Tacrolimus personalized therapy based on CYP3A5 genotype in Chinese patients with idiopathic inflammatory myopathies
Authors' conclusion
TAC treatment may elicit favorable outcome in patients with IIM and MDA5+ DM when Cmin exceeded 5.35 and 5.85 ng/ml, which is crucial to a lower relapse rate.
Study context
- Population
- Chinese patients with idiopathic inflammatory myopathies (IIM) treated with tacrolimus (TAC), including MDA5+ DM467 Cmin
- Participants
- 134 patients
- Exposure
- CYP3A5 expressers vs nonexpressers; TAC Cmin vs relapse
- Outcome
- Relationship between TAC Cmin and relapses; optimal Cmin by ROC analysis
Methodological detailsROC analysis, CYP3A5 genotype-based dosing
- ROC analysis
- CYP3A5 genotype-based dosing
Main finding
As reported in the abstract
Optimal TAC Cmin cutoff for relapse, IIM
Optimal cutoff, acute IIM (P = 0.001)
5.30 ng/ml
Optimal cutoff, subacute IIM (P = 0.013)
5.85 ng/ml
Optimal cutoff, chronic IIM (P = 0.002)
4.85 ng/ml
Optimal cutoff, all-phase IIM (P <0.001)
5.35 ng/ml
Observational data: associations, not effects.
Further findings
TAC dose required to attain target Cmin
P = 0.019
Optimal TAC Cmin cutoff for relapse, MDA5+ DM
Ng/ml
- Acute MDA5+ DM (P = 0.007)
- 5.35
- Subacute MDA5+ DM (P = 0.001)
- 5.85
- Chronic MDA5+ DM (P = 0.036)
- 5.55
- All-phase MDA5+ DM (P <0.001)
- 5.85
TAC dose required to attain target Cmin
- CYP3A5 genotype one of the significant factors influencing TAC Cmin
Original publication
Tacrolimus personalized therapy based on CYP3A5 genotype in Chinese patients with idiopathic inflammatory myopathies. Rheumatology (Oxford). Published 18 June 2024. doi:10.
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