Background: The risk of long-term chronic allograft nephropathy and graft loss after kidney transplantation is increased in patients with a high intrapatient variability of tacrolimus (Tac) clearance. Methods: To test whether this intrapatient variability is associated with an individual's CYP3A5 genotype, we measured the intrapatient variability in Tac clearance in a cohort of 208 kidney transplant recipients treated with Tac and mycophenolate mofetil. Results: Tac dose requirement was significantly higher in patients expressing CYP3A5. However, intraindividual variability of Tac clearance was not related to CYP3A5 genotype. Conclusions: Intraindividual variability in Tac clearance is not related to CYP3A5 genotype. Other factors, including patient adherence, may explain the variability in Tac clearance within an individual patient over time. Copyright

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Therapeutic Drug Monitoring
Erasmus MC: University Medical Center Rotterdam

Pashaee, N., Bouamar, R., Hesselink, D., Roodnat, J., van Schaik, R., Weimar, W., & van Gelder, T. (2011). CYP3A5 genotype is not related to the intrapatient variability of tacrolimus clearance. Therapeutic Drug Monitoring, 33(3), 369–371. doi:10.1097/FTD.0b013e31821a7aa3