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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for <i>CYP3A5</i> Genotype and Tacrolimus Dosing
Clinical Pharmacology & Therapeutics · 2015 · Vol. 98(1) · pp. 19–24
Kelly A. Birdwell✉(Vanderbilt University)Brian S. Decker(Indiana University School of Medicine)JM Barbarino(Stanford University)JF Peterson(Vanderbilt University)Catherine M. Stein(Vanderbilt University)Wolfgang Sadée(The Ohio State University)Daqing Wang(The Ohio State University)Alexander A. Vinks(University of Cincinnati Medical Center)Yijing He(Central South University)JJ Swen(Leiden University Medical Center)JS Leeder(Children's Mercy Hospital)RHN van Schaik(Erasmus University Rotterdam)KE Thummel(University of Washington)Teri E. Klein(Stanford University)KE Caudle(St. Jude Children's Research Hospital)IAM MacPhee(St George's, University of London)
Abstract
Tacrolimus is the mainstay immunosuppressant drug used after solid organ and hematopoietic stem cell transplantation. Individuals who express CYP3A5 (extensive and intermediate metabolizers) generally have decreased dose-adjusted trough concentrations of tacrolimus as compared with those who are CYP3A5 nonexpressers (poor metabolizers), possibly delaying achievement of target blood concentrations. We summarize evidence from the published literature supporting this association and provide dosing recommendations for tacrolimus based on CYP3A5 genotype when known (updates at www.pharmgkb.org).
Renal Transplantation Outcomes and TreatmentsPharmacological Effects and Toxicity StudiesPharmacogenetics and Drug MetabolismTacrolimusDosingCYP3A5PharmacogeneticsMedicineTherapeutic drug monitoringGenotypePharmacologyTransplantationInternal medicine
MeSH terms
Genetic TestingGenotypeHumansImmunosuppressive AgentsOrgan TransplantationTacrolimusHematopoietic Stem Cell TransplantationCytochrome P-450 CYP3A
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References
Sequence diversity in CYP3A promoters and characterization of the genetic basis of polymorphic CYP3A5 expression
Nature Genetics · 2001 · 2,152 citations
Lack of Improvement in Renal Allograft Survival Despite a Marked Decrease in Acute Rejection Rates Over the Most Recent Era
American Journal of Transplantation · 2004 · 1,268 citations
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