Effects of genetic variability on rifampicin and isoniazid pharmacokinetics in South African patients with recurrent tuberculosis

遗传变异对南非复发性结核病患者利福平和异烟肼药代动力学的影响

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作者:Anushka Naidoo, Maxwell Chirehwa, Veron Ramsuran, Helen McIlleron, Kogieleum Naidoo, Nonhlanhla Yende-Zuma, Ravesh Singh, Sinaye Ncgapu, John Adamson, Katya Govender, Paolo Denti, Nesri Padayatchi

Aim

We report the prevalence and effect of genetic variability on pharmacokinetic parameters of isoniazid and rifampicin. Materials &

Conclusion

Clinical relevance of the effects of genetic variation on isoniazid concentrations and low first-line tuberculosis drug exposures observed require further investigation.

Methods

Genotypes for SLCO1B1, NAT2, PXR, ABCB1 and UGT1A genes were determined using a TaqMan® Genotyping OpenArray™. Nonlinear mixed-effects models were used to describe drug pharmacokinetics.

Results

Among 172 patients, 18, 43 and 34% were classified as rapid, intermediate and slow NAT2 acetylators, respectively. Of the 58 patients contributing drug concentrations, rapid and intermediate acetylators had 2.3- and 1.6-times faster isoniazid clearance than slow acetylators. No association was observed between rifampicin pharmacokinetics and SLCO1B1, ABCB1, UGT1A or PXR genotypes.

Trial registration

ClinicalTrials.gov NCT02114684.

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