Table 3.
Drug | Genotypes | Evidence | Ref |
---|---|---|---|
Tacrolimus | CYP3A5*1/*3 | Tested in a randomized controlled trial with earlier achievement of target blood concentrations but no influence on clinical outcome. | 58 |
59 | |||
CYP3A4*22 | May provide additional predictive value to algorithms in combination with CYP3A5*1/*3. | 60 | |
POR*28 | 61 | ||
Sirolimus | CYP3A5*1/*3 | Impact on dose-normalized blood concentrations but not yet tested in a clinical trial. | 67–69 |
Cyclosporin | CYP3A5*1/*3 | Combination of genotypes may predict drug exposure but not yet replicated. | 66 |
CYP3A4*22 | |||
Azathioprine | TPMT | Predicts individuals likely to develop severe myelotoxicity. Limited adoption in transplantation with no intervention study data. | 51 |
Mycophenolate | UGT1A9 | Predicts individuals likely to be under-exposed to MPA with increased risk of rejection. | 71 |
IMPDH1 | Predicts individuals at increased risk of rejection. Genetic component to variability in MPA exposure is much smaller than other factors, limiting the potential of pharmacogenetics. |
72 |
Abbreviations: IMPDH, inosine monophosphate dehydrogenase; MPA, mycophenolic acid.