A fundamental shortcoming in the current treatment of
schizophrenia is the lack of valid criteria to predict who will respond to
antipsychotic treatment. The identification of blood-based biological markers of the therapeutic response would enable clinicians to identify the subgroup of patients in whom conventional
antipsychotic treatment is ineffective and offer alternative treatments. As part of the Optimization of Treatment and Management of
Schizophrenia in Europe (OPTiMiSE) programme, the inventors conducted a
transcriptome analysis on 188 subjects with first episode
psychosis, all of whom were subsequently treated with
amisulpride for 4 weeks. They identify 32 genes for which the expression changed
after treatment in good responders only. Among these genes, the expression of ALPL, a
gene involved in
vitamin B6
metabolism, as well as CA4, DGTA2, DHRS13, HOMER3 and WLS showed a
significant difference in expression level between good and poor responders before starting treatment, allowing to predict
treatment outcome with a
predictive value of 93.8% when combined with clinical features Collectively, these findings identified new mechanisms to explain
symptom improvement after
amisulpride medication and highlight the potential of combining
gene-expression profiling with clinical data to predict
treatment response in first episode psychoses.