Influence of genetic polymorphisms on pharmacokinetics and treatment response of mycophenolic acid: a scoping review

Pharmacogenomics. 2024;25(5-6):259-288. doi: 10.1080/14622416.2024.2344430. Epub 2024 May 16.

Abstract

This scoping review explores the impact of genetic polymorphisms on the pharmacokinetics and treatment responses of mycophenolic acid (MPA), an immunosuppressant. The study includes 83 articles from 1226 original studies, focusing on transplantation (n = 80) and autoimmune disorders (n = 3). Genetic variants in uridine 5'-diphospho-glucuronosyltransferase (UGT1A9, UGT1A8 and UGT2B7) and transmembrane transporters (ABCC2, SLCO1B1, SLCO1B3 and ABCB1) significantly affected MPA's pharmacokinetics and susceptibility to its adverse effect. Whereas variants in several genes including UGT1A9, UGT2B7, IMPDH1 and IMPDH2 have been associated with a higher risk of transplant rejection. However, there is a lack of studies on MPA's impact on autoimmune disorders and limited research on the Asian population. The findings underscore the need for further research on MPA's impact across different populations and diseases, particularly among other Asian ethnic groups, to advance personalized medicine in MPA therapy.

Keywords: immunosuppressant; mycophenolic acid; pharmacogenomics; polymorphisms.

Plain language summary

[Box: see text].

Publication types

  • Review

MeSH terms

  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / genetics
  • Glucuronosyltransferase* / genetics
  • Graft Rejection / drug therapy
  • Graft Rejection / genetics
  • Graft Rejection / prevention & control
  • Humans
  • IMP Dehydrogenase / genetics
  • Immunosuppressive Agents* / pharmacokinetics
  • Immunosuppressive Agents* / therapeutic use
  • Multidrug Resistance-Associated Protein 2*
  • Mycophenolic Acid* / pharmacokinetics
  • Mycophenolic Acid* / therapeutic use
  • Polymorphism, Genetic / genetics
  • UDP-Glucuronosyltransferase 1A9

Substances

  • Mycophenolic Acid
  • ABCC2 protein, human
  • Multidrug Resistance-Associated Protein 2
  • Immunosuppressive Agents
  • Glucuronosyltransferase
  • IMP Dehydrogenase
  • UDP-Glucuronosyltransferase 1A9
  • UDP-glucuronosyltransferase, UGT1A8