Pharmacogenetic-based strategy using de novo tacrolimus once daily after kidney transplantation: prospective pilot study.
(2016) Pharmacogenomics — Vol. 17, n° 9, p. 1019-1027 (2016)
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- (en) AIM: The once daily tacrolimus formulation (Tac-OD) has been associated with better patient adherence and low variability in exposure. Patients carrying the CYP3A5*1 allele show accelerated clearance of Tac. Authors prospectively evaluate a simplified strategy for Tac-OD administration. PATIENTS & METHODS: After grafting, 151 patients were divided into four groups and received a daily dose calculated according to CYP3A5 genotypes and unchanged for the first 3 days: CYP3A5*3/*3: 0.20 mg/kg/day, CYP3A5*3/*3: 0.25 mg/kg/day, CYP3A5*1/*3: 0.30 mg/kg/day and CYP3A5*1/*1: 0.35 mg/kg/day. The dose was adaptated on day 4 and remained unchanged a further three days and so on. RESULTS: On day 3, median Cmin fell within the therapeutic range in all study groups. CYP3A5 expressors require significantly higher Tac-OD throughout the follow-up period to achieve a comparable Cmin. CONCLUSION: This simplified strategy does not hamper treatment efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT02311010.
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De Meyer, M., Haufroid, V., Kanaan, N., Darius, T., Buemi, A., De Pauw, L., Chaïb Eddour, D., Wallemacq, P., & Mourad, M. (2016). Pharmacogenetic-based strategy using de novo tacrolimus once daily after kidney transplantation: prospective pilot study. Pharmacogenomics, 17(9), 1019-1027. https://doi.org/10.2217/pgs-2016-0005 (Original work published 2016)