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Clinical implementation of pharmacogenetics in kidney transplantation: calcineurin inhibitors in the starting blocks
Author(s) -
Elens Laure,
Bouamar Rachida,
Shuker Nauras,
Hesselink Dennis A.,
Gelder Teun,
Schaik Ron H. N.
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12253
Subject(s) - pharmacogenetics , calcineurin , medicine , tacrolimus , pharmacology , intensive care medicine , kidney transplantation , transplantation , pharmacodynamics , ciclosporin , pharmacokinetics , bioinformatics , genotype , biology , genetics , gene
Pharmacogenetics has generated many expectations for its potential to individualize therapy proactively and improve medical care. However, despite the huge amount of reported genetic associations with either pharmacokinetics or pharmacodynamics of drugs, the translation into patient care is still slow. In fact, strong evidence for a substantial clinical benefit of pharmacogenetic testing is still limited, with a few exceptions. In kidney transplantation, established pharmacogenetic discoveries are being investigated for application in the clinic to improve efficacy and to limit toxicity associated with the use of immunosuppressive drugs, especially the frequently used calcineurin inhibitors ( CNIs ) tacrolimus and ciclosporin. The purpose of the present review is to picture the current status of CNI pharmacogenetics and to discuss the most promising leads that have been followed so far.