COMT

Chr 22

catechol-O-methyltransferase

Also known as: HEL-S-98n

Catechol-O-methyltransferase catalyzes the transfer of a methyl group from S-adenosylmethionine to catecholamines, including the neurotransmitters dopamine, epinephrine, and norepinephrine. This O-methylation results in one of the major degradative pathways of the catecholamine transmitters. In addition to its role in the metabolism of endogenous substances, COMT is important in the metabolism of catechol drugs used in the treatment of hypertension, asthma, and Parkinson disease. COMT is found in two forms in tissues, a soluble form (S-COMT) and a membrane-bound form (MB-COMT). The differences between S-COMT and MB-COMT reside within the N-termini. Several transcript variants are formed through the use of alternative translation initiation sites and promoters. [provided by RefSeq, Sep 2008]

GeneReviewsOMIMResearchGenerating clinical summary…
GOFmechanismLOEUF 1.701 OMIM phenotype
Clinical SummaryCOMT
Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
1 unique Pathogenic / Likely Pathogenic· 40 VUS of 85 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — COMT
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint?
1.70LOEUF
pLI 0.000
Z-score -0.04
OE 1.02 (0.611.70)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint?
0.43Z-score
OE missense 0.91 (0.801.04)
157 obs / 172.9 exp
Tolerant

Mild missense constraint

Observed / Expected Ratios?
LoF OE?1.02 (0.611.70)
00.351.4
Missense OE?0.91 (0.801.04)
00.61.4
Synonymous OE?0.94
01.21.6
LoF obs/exp: 9 / 8.9Missense obs/exp: 157 / 172.9Syn Z: 0.45

This gene — mechanism propensity

DN
0.6163th %ile
GOF
0.6443th %ile
LOF
0.2969th %ile

The highest-scoring mechanism for this gene is gain-of-function.

GOFprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

85 submitted variants in ClinVar

Classification Summary

Pathogenic1
VUS40
Likely Benign25
Benign17
1
Pathogenic
40
VUS
25
Likely Benign
17
Benign

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
1
0
0
0
1
Likely Pathogenic
0
0
0
0
0
VUS
1
30
9
0
40
Likely Benign
0
1
7
17
25
Benign
0
2
7
8
17
Total233232583

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

393 pathogenic / likely-pathogenic (of 412) ClinVar copy-number / structural variants overlap COMT — these span large chromosomal regions, not the gene specifically, and are excluded from the counts above. Explore in CNV tools →

Protein Context — Lollipop Plot

COMT · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Sleep ApneaSleep-Disordered Breathing

The Meaning of Dopaminergic Pathway in Sleep Breathing Disorders.

ENROLLING BY INVITATION
NCT05890911Wroclaw Medical UniversityStarted 2023-06-01
PolysomnographyBlood dopamine level measurementGenetical test
Patients With Schizophrenia

PhaRmacOgenetics and Therapeutic Drug Monitoring In SchizophrEnia

NOT YET RECRUITING
NCT05839613Phase NAAssistance Publique Hopitaux De MarseilleStarted 2023-05
Therapeutic Drug Monitoring (TDM) and Pharmacogenetics (PG)
PPAPSpine Fusion

Personalized Perioperative Analgesia Platform (PPAP) for Pediatric Spine Fusion Surgery (sIRB)

RECRUITING
NCT05367609Phase NASenthil SadhasivamStarted 2022-09-20
Preoperative Genotyping
Breast CancerChronic PainAcute Pain

Evaluation And Risk Assessment For Persistent Postsurgical Pain After Breast Surgery

ACTIVE NOT RECRUITING
NCT03408717KK Women's and Children's HospitalStarted 2018-01-03
QuestionnairesMechanical Temporal Summation assessmentPain threshold assessment
Healthy

Effect of Sleep Extension in Prevention to Sleep Deprivation

RECRUITING
NCT06928168Phase NACentre Hospitalier Universitaire de Saint EtienneStarted 2025-06-12
Total sleep deprivationpartial sleep deprivationReproductibility
Stage I Breast Cancer AJCC v7Stage IA Breast Cancer AJCC v7Stage IB Breast Cancer AJCC v7

Electroacupuncture Therapy in Reducing Chronic Pain in Patients After Breast Cancer Treatment

ACTIVE NOT RECRUITING
NCT02754752Phase PHASE2M.D. Anderson Cancer CenterStarted 2016-09-13
Electroacupuncture TherapyElectroacupuncture TherapyLaboratory Biomarker Analysis
Mild Cognitive Impairment

REACT MCI - Repeated Advanced Cognitive Training in Mild Cognitive Impairment

ACTIVE NOT RECRUITING
NCT04792528Phase NASorlandet Hospital HFStarted 2021-05-15
Computerized cognitive training.Generalized brain training / Active control
Fibromyalgia (FM)tDCSDuloxetine

Home-based Transcranial Direct Current Stimulation (tDCS) Compared to Duloxetine: Non-inferiority Clinical Trial (FIBROSTIM)

RECRUITING
NCT07203339Phase NAHospital de Clinicas de Porto AlegreStarted 2025-09-30
Transcranial direct current stimulation (tDCS) plus placebo.Duloxetine (60 mg) once dailyHome-based transcranial direct current stimulation
Vasovagal Syncope

Study of Atomoxetine in the Prevention of Vasovagal Syncope

RECRUITING
NCT05159687Phase PHASE3University of CalgaryStarted 2022-06-01
Atomoxetine HydrochloridePlacebo
AnalgesiaCardiac Surgery

Precision Analgesia for Cardiac Surgery

NOT YET RECRUITING
NCT05612399Kathirvel SubramaniamStarted 2026-05
Opioid Use DisorderPregnancy Related

Predicting and Preventing Adverse Maternal and Child Outcomes of Opioid Use Disorder in Pregnancy

RECRUITING
NCT05942313Ilana HullStarted 2023-08-28
Buprenorphine/ Methadone exposure
CannabisTHC

Modulation of THC Effects by CBD: a Dose-ranging Study

RECRUITING
NCT06099379Phase PHASE1, PHASE2Centre hospitalier de l'Université de Montréal (CHUM)Started 2024-06-27
∆9-tetrahydrocannabinol