Naslov
Interaction between <i>ABCG2 421C>A</i> polymorphism and valproate in their effects on steady-state disposition of lamotrigine in adults with epilepsy
(Interaction between <i>ABCG2 421C>A</i> polymorphism and valproate in their effects on steady-state disposition of lamotrigine in adults with epilepsy)

Autori
Klarica Domjanović, Iva ; Lovrić, Mila ; Trkulja, Vladimir ; Petelin-Gadže, Željka ; Ganoci, Lana ; Čajić, Ivana ; Božina, Nada

Izvornik
British Journal of Clinical Pharmacology (0306-5251) 84 (2018), 9; 2106-2119

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
clinical pharmacology ; drug interactions ; drug transporter ; genetics and pharmacogenetic ; pharmacogenomics ; pharmacokinetics.
(clinical pharmacology ; drug interactions ; drug transporter ; genetics and pharmacogenetic ; pharmacogenomics ; pharmacokinetics)

Sažetak
Aims: To investigate the impact of glucuronidation enzyme (UGT1A4*3 142T>G, UGT1A4*2 70C>A, UGT2B7 -161C>T) and transporter (MDR1/ABCB1 1236C>T, ABCG2 421C>A) polymorphisms on steady-state disposition of lamotrigine and on the lamotrigine- valproate interaction. Methods: Adults with epilepsy on lamotrigine monotherapy (n = 131) or lamotrigine + valproate treatment (n = 74) were genotyped and steady-state lamotrigine and valproate morning troughs were determined as a part of routine therapeutic drug monitoring. Results: No effect of UGT and MDR1/ABCB1 polymorphisms was observed. In the entire cohort, ABCG2 421A allele had no effect however an interaction between the variant allele and valproate was observed: (i) in lamotrigine-only patients, variant allele (vs. wild type homozygosity) was independently (adjustments: age, sex, body mass index, lamotrigine dose, other polymorphisms) associated with mildly lower lamotrigine troughs [geometric means ratio (GMR) = 0.76, 95% confidence interval (CI) 0.59-0.98], whereas in lamotrigine + valproate patients it was associated with higher troughs (GMR = 1.72, 95%CI 1.14-2.62) ; (ii) valproate cotreatment was overall associated with markedly higher troughs vs. lamotrigine monotherapy (GMR = 3.49, 95%CI 2.73- 4.44), but more so in variant allele carriers (GMR = 5.24, 95%CI 3.38-8.15) than in wild type homozygotes (GMR = 2.32, 95%CI 1.89- 2.83) ; (iii) variant allele effects in two treatment subsets and valproate effects in two genotype subsets differed by 2.36-fold (95%CI 1.39-3.67) ; (iv) increase in lamotrigine troughs associated with increasing valproate troughs was greater in variant allele carriers than in wild type homozygotes, i.e. variant allele effect increased with increasing valproate troughs. Conclusion: This study is first to indicate a potentially relevant interaction between ABCG2 421C>A polymorphism and valproate in their effects on lamotrigine disposition.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA