Pharmacogenetics of immunosuppressants: State of the art and clinical implementation – recommendations from the French National Network of Pharmacogenetics (RNPGx) - 18/03/17

Doi : 10.1016/j.therap.2016.09.016

Jean-Baptiste Woillard ^a,^b,^⁎ , Laurent Chouchana ^c, Nicolas Picard ^a,^b, Marie-Anne Loriot ^d,^e,^f
the
French Network of Pharmacogenetics (RNPGX)
^a Service de pharmacologie, toxicologie et pharmacovigilance, centre de biologie et de recherche en santé, CHU de Limoges, 87042 Limoges, France
^b Université de Limoges UMR_S850, 87000 Limoges, France
^c Service de pharmacologie, hôpital Cochin, Assistance publique–Hôpitaux de Paris (AP–HP), 75014 Paris, France
^d Inserm UMR_S1147, centre universitaire des Saints-Pères, 75006 Paris, France
^e Université Paris Descartes, Sorbonne Paris Cité, 75006 Paris, France
^f Service de biochimie, hôpital européen Georges-Pompidou, Assistance publique–Hôpitaux de Paris (AP–HP), 75015 Paris, France

^⁎Corresponding author at: Service de pharmacologie, toxicologie et pharmacovigilance, CBRS – 2^e étage, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France.

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Summary

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.

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Keywords : Pharmacogenetics, Pharmacogenomics, Immunosuppressants, Transplantation, Clinical implementation