BACKGROUND

Sub-Saharan Africa (SSA) population is genetically diverse and heterogenous thus variability in drug response among individuals is predicted to be high. Cytochrome P450 (CYP450) polymorphisms is a major source of variability in drug response. This systematic review presents the influence of CYP450 single nucleotide polymorphisms (SNPs), particularly CYP3A41B, CYP2B66 and CYP3A5*3 on antimalarial drug plasma concentrations, efficacy and safety in SSA populations.

METHODS

Searching for relevant studies was done through Google Scholar, Cochrane Central Register of controlled trials (CENTRAL), PubMed, Medline, LILACS, and EMBASE online data bases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were used. Two independent reviewers extracted data from the studies.

RESULTS

Thirteen studies reporting the influence of CYP450 SNPs on plasma concentrations, efficacy and safety were included in the final data synthesis. CYP3A41B, CYP3A55, CYP2B66 and CYP2C82 did not affect antimalarial drug plasma concentration significantly. There was no difference in treatment outcomes between malaria patients with variant alleles and those with wild type alleles.

CONCLUSION

This review reports lack of influence of CYP3A41B, CYP3A53, CYP2C83 and CYP2B66 SNPs on PK profiles, efficacy and safety in SSA among malaria patients.