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Long-Term Clinical Impact of Adaptation of Initial Tacrolimus Dosing to CYP3A5Genotype

Authors :
Pallet, N.
Etienne, I.
Buchler, M.
Bailly, E.
Hurault de Ligny, B.
Choukroun, G.
Colosio, C.
Thierry, A.
Vigneau, C.
Moulin, B.
Le Meur, Y.
Heng, A.-E.
Legendre, C.
Beaune, P.
Loriot, M.A.
Thervet, E.
Source :
American journal of transplantation; September 2016, Vol. 16 Issue: 9 p2670-2675, 6p
Publication Year :
2016

Abstract

Pretransplantation adaptation of the daily dose of tacrolimus to CYP3A5genotype is associated with improved achievement of target trough concentration (C0), but whether this improvement affects clinical outcomes is unknown. In the present study, we have evaluated the long-term clinical impact of the adaptation of initial tacrolimus dosing according to CYP3A5genotype: The transplantation outcomes of the 236 kidney transplant recipients included in the Tactique study were retrospectively investigated over a period of more than 5 years. In the Tactique study, patients were randomly assigned to receive tacrolimus at either a fixed dosage or a dosage determined by their genotype, and the primary efficacy end point was the proportion of patients for whom tacrolimus C0was within target range (10–15 ng/mL) at day 10. Our results indicate that the incidence of biopsy-proven acute rejection and graft survival were similar between the control and the adapted tacrolimus dose groups, as well as between the patients who achieve the tacrolimus C0target ranges earlier. Patients’ death, cancer, cardiovascular events, and infections were also similar, and renal function did not change. We conclude that optimization of initial tacrolimus dose using pharmacogenetic testing does not improve clinical outcomes.

Details

Language :
English
ISSN :
16006135 and 16006143
Volume :
16
Issue :
9
Database :
Supplemental Index
Journal :
American journal of transplantation
Publication Type :
Periodical
Accession number :
ejs62084896
Full Text :
https://doi.org/10.1111/ajt.13788