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Effect of hepatic drug transporter polymorphisms on the pharmacokinetics of mycophenolic acid in patients with severe renal dysfunction before renal transplantation.

Abstract
1. The objective of this study was to examine the association of UGT1A9, SLCO, and ABCC polymorphisms with mycophenolic acid (MPA) pharmacokinetics in ABO blood type (ABO) incompatible patients with severe renal dysfunction pre-transplantation. 2. In all patients, on day 14 after beginning mycophenolate mofetil (MMF) treatment (1 week before transplantation) and on day 28 after renal transplantation, samples were collected just prior to and 1, 2, 3, 4, 6, 9, and 12 h after oral MMF administration. 3. The median dose-adjusted AUC0-12 of MPA after renal transplantation was significantly lower than before transplantation (57.9 versus 76.5 μg h/mL, respectively, p = 0.002). 4. Although the enterohepatic circulation of MPA pre-transplantation was extremely high (57.6%), this level was significantly reduced after renal transplantation (34.6%). 5. In the multivariate analysis, pre-transplantation, patients with the SLCO1B3 334T allele (p = 0.003), higher alanine aminotransferase (p = 0.002), and lower body weight were independently predictive for a higher dose-adjusted AUC0-12 of MPA. 6. In patients with severe renal dysfunction pre-transplantation, MPA is excreted mainly to bile from the liver, and as a consequence, the SLCO1B3 334T > G polymorphism was found to be significantly associated with MPA exposure.
AuthorsHideaki Kagaya, Takenori Niioka, Mitsuru Saito, Takamitsu Inoue, Kazuyuki Numakura, Tomonori Habuchi, Shigeru Satoh, Masatomo Miura
JournalXenobiotica; the fate of foreign compounds in biological systems (Xenobiotica) Vol. 47 Issue 10 Pg. 916-922 (Oct 2017) ISSN: 1366-5928 [Electronic] England
PMID27616538 (Publication Type: Journal Article)
Chemical References
  • Immunosuppressive Agents
  • UGT1A9 protein, human
  • Glucuronosyltransferase
  • UDP-Glucuronosyltransferase 1A9
  • Mycophenolic Acid
Topics
  • Area Under Curve
  • Female
  • Glucuronosyltransferase (genetics)
  • Humans
  • Immunosuppressive Agents (pharmacokinetics)
  • Kidney (metabolism)
  • Kidney Transplantation
  • Male
  • Middle Aged
  • Mycophenolic Acid (pharmacokinetics)
  • Polymorphism, Single Nucleotide
  • UDP-Glucuronosyltransferase 1A9

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