CYP2D6-Guided Opioid Management and Postoperative Pain Control: A Randomized Clinical Trial
Primary resultResult — go to the resultDifference 2.8 95% CI −18.3 to 23.8Authors' conclusion
In this randomized clinical trial of CYP2D6-guided postoperative opioid prescribing, there were significant prescribing changes in CYP2D6 poor and intermediate metabolizers but no differences in pain control compared with usual care.
Study context
- Population
- CYP2D6 poor or intermediate metabolizers undergoing planned surgery anticipated to cause postoperative pain for at least 7 to 10 days, 8 US health systems1,602 enrolled
- Participants
- 351 participants
- Comparison
- CYP2D6-guided opioid prescribing vs usual pain management
- CYP2D6-guidedn = 176
- Controln = 175reference
- Primary endpoint
- Silverman integrated analgesic assessment (SIA) score (rank-based composite of average pain intensity and opioid use in MME)
- Follow-up
- 10 days
Methodological detailsopen-label, multicentre
- Open-label
- Multicentre
Primary result
As reported in the abstract
Difference
2.8
95% CI −18.3 to 23.8
P = 0.80
By group
CYP2D6-guided
1.4
mean · SD 95.9
Control
−1.4
mean · SD 93.1
CYP2D6-guided vs Control
difference 2.8 (95% CI −18.3 to 23.8); P = 0.80
Secondary outcomes
| Outcome | CYP2D6-guided | Control | Difference (percentage points) (95% CI) | P value | |
|---|---|---|---|---|---|
| Concordance between postsurgical opioid treatment and CYP2D6 phenotype | 64% | 27% | 37 (27–46) | P < 0.001 | |
| −200204060Difference, percentage points (linear scale) |
Overall opioid use
Mean
| Outcome | CYP2D6-guided | Control |
|---|---|---|
| Numeric pain intensity rating | 5.2 (SD 2.2) | 5.1 (SD 2.3) |
Numeric pain intensity rating
- Did not differ between arms
Overall opioid use
- Did not differ between arms; other secondary end points also did not differ
Original publication
CYP2D6-Guided Opioid Management and Postoperative Pain Control: A Randomized Clinical Trial. JAMA Netw Open. Published 2 February 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →