Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients / 中国药房
China Pharmacy
; (12): 1765-1769, 2024.
Article
in Zh
| WPRIM
| ID: wpr-1039358
Responsible library:
WPRO
ABSTRACT
OBJECTIVE To investigate the effects of CYP3A5 gene polymorphism and Wuzhi capsule (WZ) on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients. METHODS A total of 132 patients who underwent renal transplantation and received tacrolimus + mycophenolic acids + prednisone after operation in our hospital from September 2021 to September 2023 were selected and divided into four groups according to genotypes (CYP3A5*1 or CYP3A5*3/*3) and with or without WZ (“ +WZ” meant drug combination, “ +NO WZ” meant without combination). The blood trough concentration/daily dose (c0/D) values of the four groups were analyzed on the 14th day, 1 month and 3 months after renal transplantation. The incidence of acute rejection and the incidence of tacrolimus-related adverse reactions within 3 months after transplantation were compared among 4 groups. RESULTS On the 14th day, 1 month and 3 months after surgery (except for the CYP3A5*1+WZ group), c0/D values of CYP3A5*1 genotype patients were significantly lower than those of CYP3A5*3/*3 genotype patients regardless of whether they were treated with WZ additionally (P<0.05). Within 3 months after surgery, although there was no significant difference in the incidence of acute rejection and tacrolimus-related adverse reactions among the four groups (P> 0.05), the incidence of hyperglycemia in patients with CYP3A5*3/*3 was higher (41.67%). CONCLUSIONS CYP3A5 gene polymorphism is significantly related to tacrolimus c0/D in kidney transplant patients. Under the premise of c0 monitoring of tacrolimus, patients with CYP3A5*1 genotype should be given WZ as soon as possible after surgery to accelerate tacrolimus to reach the therapeutic concentration range, while CYP3A5*3/*3 genotype is not recommended to be given WZ because of the higher risk of hyperglycemia.
Full text:
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Database:
WPRIM
Language:
Zh
Journal:
China Pharmacy
Year:
2024
Document type:
Article