title: [Applied pharmacogenetic].
abstract: Pharmacokinetics is the link between genetic data and the use of treatments. It can be use on several relevant aspects in the clinic, including the treatment selection, efficacy or toxicity prediction and the choice of the dose. Pharmacogenetics has been applied in clinical nephrology since a long time by the genetic prediction of azathiorpine associated myelotoxicity. However, despite an extensive literature describing the links between genetics and metabolism and transport of drugs, genetic tests are little used in clinical practice. One reason for this poor implementation is the current lack of evidence of improved clinical outcomes with pharmacogenetic tests. In addition, with an effective therapeutic drug monitoring, it is possible to correct the effect of genotype on the pharmacokinetic differences, thus reducing the usefulness of the assay based on the genotype. The future of pharmacogenetics will be treatment models in which patient characteristics are combined with data on polymorphisms in multiple genes including pharmacodynamic parameters, drug transporter proteins, and predictors of toxicity.
authors.affiliation: Service de néphrologie, département hypertension artérielle, prévention et prise en charge des maladies rénales et cardiovasculaires, hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France. Electronic address: eric.thervet@aphp.fr.
authors.forename: Éric
authors.initials: É
authors.lastname: Thervet
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000008:administration & dosage; D016572:Cyclosporine / Q000008:administration & dosage; D000068338:Everolimus / Q000008:administration & dosage; D005838:Genotype; D006801:Humans; D007168:IMP Dehydrogenase / Q000037:antagonists & inhibitors; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives*; D009369:Neoplasms / Q000188:drug therapy* / Q000235:genetics; D009398:Nephrology; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D016559:Tacrolimus / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D007168:IMP Dehydrogenase; C488211:IMPDH1 protein, human; D009173:Mycophenolic Acid; D001379:Azathioprine; D016559:Tacrolimus
keywords: Immunosuppressive treatment; Pharmacogenetic; Pharmacogenomic; Pharmacogénétique; Traitements immunosuppresseurs