Postoperative Pain in Patients Receiving Ketoprofen After Total Hip Arthroplasty: The Role of Pharmacogenetics

Background: Ketoprofen is one of the most commonly prescribed NSAIDs; however, its pharmacogenetics remains poorly understood. The objective was to evaluate the influence of patients’ pharmacogenetic profiles on the effectiveness of ketoprofen for postoperative pain management after total hip arthroplasty, including postoperative analgesia (pain levels, opioid consumption) and the incidence of adverse reactions during hospitalization and up to 12 months post-surgery. Methods: The study included 53 patients (31 (58.49%) women, median age 66.0 60.0–74.0 years) undergoing total hip arthroplasty. Genotyping was performed using real-time PCR to analyze 18 single-nucleotide polymorphisms (SNPs) across the following genes: CYP2C9 (rs1799853, rs1057910), CYP2C8 (rs10509681, rs11572080), CYP3A4 (rs35599367), CYP3A5 (rs776746), UGT2B7 (rs73823859, rs7439366, rs7668282), ABCB1 (rs1045642, rs4148738, rs2032582, rs1128503), PTGS1 (rs10306135, rs12353214), PTGS2 (rs20417), C3orf20 (rs12496846), and ZNF493-ZNF429 (rs2562456). Results: We did not find significant associations between patients’ genotypes and pain levels or postoperative opioid analgesic consumption or adverse reactions when ketoprofen was used for pain management in patients undergoing total hip arthroplasty. Conclusions: Routine pharmacogenetic testing for ketoprofen is not supported by our findings.