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Research Article

Genotype-based Tacrolimus Dosing Guidelines: with or without CYP3A4*22?

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Pages 1473-1480 | Received 24 Jul 2017, Accepted 25 Aug 2017, Published online: 02 Nov 2017
 

Abstract

Aim: To test the relevance of revisiting the genotype classification based on CYP3A5*3 solely by incorporating CYP3A4*22 information. Methods: Discriminant analysis of principal component was performed to evaluate the relevance of either the CYP3A (CYP3A5 + CYP3A4 genotypes) or CYP3A5*3 classification variables. This analysis was based on a linear combination of noncompartmental pharmacokinetics parameters. Results: Discriminant analysis of principal component gave better results with CYP3A compared with CYP3A5*3 clustering. The centroid means of the pharmacokinetics variables were significantly different with CYP3A genotype clustering (p = 0.04) but not with CYP3A5*3 solely (p = 0.06). Canonical plots reveal a better delimitation of clusters with CYP3A genotype compared with CYP3A5*3 and the reciever operating characteristic curves confirm this better discriminative power. Conclusion: We provide strong arguments of incorporating CYP3A4*22 genotype in practice to fine-tune the existing Clinical Phamacogenetics Implementation Consortium guidelines in the Caucasian population.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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