6533b871fe1ef96bd12d1b2d
RESEARCH PRODUCT
Effect of CYP3A5*3 on kidney transplant recipients treated with tacrolimus: a systematic review and meta-analysis of observational studies
Juan Eduardo MegíasJ Luis PovedaLuis RojasVirginia BosóM José HerreroSergio BeaSalvador F. AliñoJ ReigI Neumannsubject
Graft Rejectionmedicine.medical_specialtyPharmacologyGastroenterologyKidney transplantTacrolimusPharmacokineticsInternal medicineGenotypeGeneticsmedicineCytochrome P-450 CYP3AHumansAlleleCYP3A5Pharmacologybusiness.industryKidney TransplantationTransplant RecipientsTacrolimusObservational Studies as Topicsurgical procedures operativeMeta-analysisMolecular MedicineObservational studybusinessImmunosuppressive Agentsdescription
The highly variable pharmacokinetics of tacrolimus can hamper the optimal management of kidney transplant patients. This variability has been attributed to the genetic polymorphism of CYP3A5 6986A>G, but the evidence is not clear. We conducted a meta-analysis of studies evaluating the effect of CYP3A5 polymorphism on kidney transplant recipients with tacrolimus plasma concentration divided by daily dose per body weight (C/D) and clinical outcomes. We searched in MEDLINE and EMBASE. We found evidence suggesting a significantly lower C/D among CYP3A5*1 allele carriers compared with carriers of the CYP3A5*3/*3 genotype at weeks 1 and 2, and months 1, 3, 6 and 12. We demonstrated that the expresser genotype might have higher risk of acute rejection and chronic nephrotoxicity. In conclusion, CYP3A5 6986A>G polymorphism can affect tacrolimus pharmacokinetics and the incidence of acute rejection and chronic nephrotoxicity on kidney transplant recipients. Patients at high risk of developing tacrolimus-related complications could be detected even before their kidney transplant.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-09-09 |