移植医学中药物遗传学的实用性。

Practicability of pharmacogenetics in transplantation medicine.

机构信息

1] Department of Hospital Pharmacy, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands [2] Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.

出版信息

Clin Pharmacol Ther. 2014 Mar;95(3):262-4. doi: 10.1038/clpt.2013.169. Epub 2013 Aug 29.

DOI:10.1038/clpt.2013.169

PMID:23995265

Abstract

Implementation of pharmacogenetics in transplantation medicine has not met the expectations expressed 15 years ago. Numerous studies have reported associations between gene polymorphisms and pharmacokinetics of immunosuppressive drugs. Evidence that genotype-based dosing improves outcome is lacking. Extensive therapeutic drug monitoring (TDM) can rapidly correct for the variability in drug exposure caused by genetic differences. The contribution of genotype-based dosing will be more pronounced for drugs for which pharmacokinetic or pharmacodynamic monitoring is not applied.

摘要

移植医学中实施药物遗传学的效果并未达到 15 年前所表达的期望。大量研究报告了基因多态性与免疫抑制剂药物药代动力学之间的关系。但是，基于基因型的给药方案并未改善治疗结果。尽管广泛的治疗药物监测（TDM）可以快速纠正由于遗传差异导致的药物暴露变异性，但在未进行药代动力学或药效动力学监测的药物中，基于基因型的给药方案的贡献将更加明显。