Integration of tacrolimus pharmacogenetics into medication therapy management in kidney transplant patients

Authors

DOI:

https://doi.org/10.33448/rsd-v10i10.18589

Keywords:

Tacrolimus; Polymorphism, single nucleotide (SNP); Kidney transplantation; Pharmacogenomics; Pharmacogenetics; Cytochrome P-450 CYP3A Inducers; Medication therapy management; Precision medicine; Clinical pharmacy.

Abstract

The pharmacogenetic analysis of tacrolimus and medication therapy management have already been analyzed in isolation as clinical strategies in renal transplant patients, and studies on the integration of these two practices are still scarce. The objective of this research was to integrate these tools in the care of kidney transplant patients. This is a retrospective observational study with 70 patients, 42 of whom were being treated by the medication therapy management service. We analyzed gender, age, time since the transplant, type of donor and drug-related problems. The allelic frequency of CYP3A5 (rs776746) was obtained by identifying the individuals regarding the presence of the functional *1 allele (expressors). There was a tacrolimus higher plasma concentration in expressors, but without change in the mean dose of this drug between groups. Regarding the frequency of drug-related problems, it was observed that 11 (27%) patients had none, 19 (47.5%) had only one, and 5 (12.5%), two or three. The integration of tacrolimus pharmacogenetics is a useful and complementary tool to the results obtained with the medication therapy management, as significant changes in the plasma concentration of this drug in expressors can signal to the multidisciplinary team a need for more attention in monitoring these patients, in order to avoid problems of effectiveness, safety and convenience. Furthermore, the identification of other health problems of the patient makes the medication therapy management necessary to ensure the use of medications appropriate, effective and safe.

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Published

05/08/2021

How to Cite

OLIVEIRA , I. D. G. de .; REIS , P. M. dos .; REIS, E. A. .; GOMES , K. B. .; MOTA , A. P. L. .; CHEMELLO, C. Integration of tacrolimus pharmacogenetics into medication therapy management in kidney transplant patients . Research, Society and Development, [S. l.], v. 10, n. 10, p. e52101018589, 2021. DOI: 10.33448/rsd-v10i10.18589. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18589. Acesso em: 27 oct. 2021.

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Health Sciences