Current Pharmaceutical DesignCurrent Pharmaceutical DesignCurrent Pharmaceutical Design1381-61281873-4286Bentham Science64596810.2174/0113816128324199240730093415Immunology, Inflammation & AllergyResearch ArticleEffects of CYP3A5 Genetic Polymorphisms on the Weight-adjusted through Concentration of Sirolimus in Renal Transplant Recipients: A Systematic Review and Meta-analysisParkYoon-Ainfo@benthamscience.netParkJuyeonginfo@benthamscience.netYeeJeonginfo@benthamscience.netGwakHye Suninfo@benthamscience.netCollege of Pharmacy and Graduate School of Pharmaceutical Sciences,, Ewha Womans UniversityCollege of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans UniversitySchool of Pharmacy, Sungkyunkwan University2010202430393108311511012025Copyright ©; 2024, Bentham Science Publishers2024Bentham Science Publishershttps://journals.eco-vector.com/1381-6128/article/view/645968

Background:Sirolimus, one of the immunosuppressive drugs administered to renal transplant recipients, is metabolized by cytochrome P450 (CYP) 3A5. Accordingly, CYP3A5 polymorphism is a genetic factor affecting sirolimus pharmacokinetics (PK). Therefore, we conducted a systematic review and meta-analysis on the association between sirolimus PK and CYP3A5*3 polymorphism.

Methods:We searched for studies published up to 13 June 2024 from PubMed, Embase, Cochrane Library, and Web of Science. We reviewed studies on the relationship between CYP3A5*3 polymorphism and weightadjusted trough concentration/dose (C0 /D) ratio and dosage of sirolimus in renal transplant recipients, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We evaluated mean differences (MDs) and 95% confidence intervals (CIs).

Results:A total of seven studies were included. The weight-adjusted C0 /D ratio of sirolimus was significantly higher in patients with the CYP3A5*3/*3 rather than CYP3A5*1/*1 or CYP3A5*1/*3 genotype (MD 95.27 ng/mL per mg/kg; 95% CI: 58.06, 132.47; I2 = 74%; p < 0.00001). Also, the weight-adjusted dosage of sirolimus was significantly lower in patients with the CYP3A5*3/*3 rather than CYP3A5*1/*1 or CYP3A5*1/*3 genotype (MD -2.60 × 10-3 mg/kg; 95% CI: -4.52, -0.69; I2 = 44%; p = 0.008).

Conclusion:Our meta-analysis showed a significant effect for the CYP3A5*3 genotype on weight-adjusted C0 /D ratio and dosage of sirolimus in adult renal transplant recipients.

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