Woillard Jean-Baptiste, Chouchana Laurent, Picard Nicolas, Loriot Marie-Anne
Service de pharmacologie, toxicologie et pharmacovigilance, centre de biologie et de recherche en santé, CHU de Limoges, 87042 Limoges, France; Université de Limoges UMR_S850, 87000 Limoges, France.
Service de pharmacologie, hôpital Cochin, Assistance publique-Hôpitaux de Paris (AP-HP), 75014 Paris, France.
Therapie. 2017 Apr;72(2):285-299. doi: 10.1016/j.therap.2016.09.016. Epub 2017 Jan 30.
Therapeutic drug monitoring is already widely used for immunosuppressive drugs due to their narrow therapeutic index. This article summarizes evidence reported in the literature regarding the pharmacogenetics of (i) immunosuppressive drugs used in transplantation and (ii) azathioprine used in chronic inflammatory bowel disease. The conditions of use of currently available major pharmacogenetic tests are detailed and recommendations are provided based on a scale established by the RNPGx scoring tests as "essential", "advisable" and "potentially useful". Other applications for which the level of evidence is still debated are also discussed.
由于免疫抑制药物的治疗指数较窄,治疗药物监测已广泛应用于此类药物。本文总结了文献中报道的关于(i)移植中使用的免疫抑制药物和(ii)用于慢性炎症性肠病的硫唑嘌呤的药物遗传学证据。详细介绍了目前可用的主要药物遗传学检测的使用条件,并根据RNPGx评分检测确定的“必要”、“建议”和“可能有用”的标准提供了建议。还讨论了证据水平仍存在争议的其他应用。