Pharmacogenetics of immunosuppressants: State of the art and clinical implementation - recommendations from the French National Network of Pharmacogenetics (RNPGx)

Therapie. 2017 Apr;72(2):285-299. doi: 10.1016/j.therap.2016.09.016. Epub 2017 Jan 30.

Abstract

Therapeutic drug monitoring is already widely used for immunosuppressive drugs due to their narrow therapeutic index. This article summarizes evidence reported in the literature regarding the pharmacogenetics of (i) immunosuppressive drugs used in transplantation and (ii) azathioprine used in chronic inflammatory bowel disease. The conditions of use of currently available major pharmacogenetic tests are detailed and recommendations are provided based on a scale established by the RNPGx scoring tests as "essential", "advisable" and "potentially useful". Other applications for which the level of evidence is still debated are also discussed.

Keywords: Clinical implementation; Immunosuppressants; Pharmacogenetics; Pharmacogenomics; Transplantation.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / genetics
  • Cytochrome P-450 CYP3A / genetics
  • Genotype
  • Glucuronosyltransferase / genetics
  • Humans
  • Immunosuppressive Agents / pharmacokinetics*
  • Inflammatory Bowel Diseases / drug therapy
  • Methyltransferases / genetics
  • Organ Transplantation
  • Pharmacogenetics*
  • Pharmacogenomic Testing
  • Polymorphism, Genetic

Substances

  • ABCB1 protein, human
  • ATP Binding Cassette Transporter, Subfamily B
  • Immunosuppressive Agents
  • Cytochrome P-450 CYP3A
  • Methyltransferases
  • thiopurine methyltransferase
  • Glucuronosyltransferase