Meta-analysis About the Effect of CYP2D6 Gene Polymorphisms on Efficacy of Metoprolol

OBJECTIVE To evaluate the effect of cytochrome P450 2D6 (CYP2D6) drug metabolic enzyme gene polymorphism on the efficacy of metoprolol. METHODS Literature on CYP2D6 and metoprolol published since the establishment of the database and end in July 2019 was searched from various databases(CNKI, VIP, Wanfang, SCIE, PubMed and Embase), and the literature was screened and included into the quality evaluation, and the literature data was extracted. RevMan 5.3 was used to conduct quantitative meta-analysis on the outcome indicators of all included literatures. RESULTS A total of 8 references were included, including 631 cases in the non-poor metabolizer(non-PM) group and 206 cases in the poor metabolizer(PM) group. The systolic blood pressure(SBP) reduction in the PM group was larger than that in the non-PM group, with no statistically significant difference(P=0.20). Comparison within the non-PM group, the SBP reduction in the intermediate metabolizer(IM) group was better than that in the extensive metabolizer(EM) group, with statistically significant difference(P=0.03). The effect of diastolic blood pressure(DBP) reduction in PM group was better than that in non-PM group, with statistically significant difference(P=0.01). The value of DBP reduction in EM group was lower than that in IM group, with statistically significant difference(P=0.02). The decreased heart rate(HR) value of non-PM group was higher than that of PM group, with statistically significant difference(P=0.05). The decreased HR value of IM group was higher than that of EM group(P=0.002). CONCLUSION The result of meta-analysis shows that the hypotensive effect of the PM group is better than that of the non-PM groups(UM, EM and IM group), mainly in decrease DBP, and the efficacy of HR control is weaker than that of the non-PM groups.