Combined Influence of Genetic Variants and Gene-gene Interaction on Sulfonylurea Efficacy in Type 2 Diabetic Patients

Pharmacogenomics of sulfonylureas in type 2 diabetes mellitus; a systematic review

Purpose

Genetic factors have a role in response to a target medication (personalized medicine). This study aimed to review available evidence about the relationship between gene variants and therapeutic response to sulfonylureas in type 2 diabetes, systematically.

Methods

An extensive search was done in Scopus, PubMed, and Web of Science with specific search strategy in the field from the beginning until the 1st of Jan. 2021. After sending records to endnote software and removing duplicate records remained documents were screened by title and abstract. Full texts of remained documents were assessed after removing un-related records. Required data was extracted from remained documents and records were categorized according to gene/SNP studied.

Results

Finally, 26 studies with 9170 T2DM patients with a mean age of 59.47 ± 6.67 (49.7-75.2 years) remained. The most contribution was from China, Slovakia and Greece, respectively and the most genes studied were CYP2C9, KCNJ11, and both KCNQ1 and ABCC8 with 10, 7, and 4 articles, respectively. Also, rs1799853 and rs1057910 (each with seven studies), rs5219 with six studies and CYP2C9*1(with four articles), respectively were the most common variants investigated. Studies about each gene obtained different positive or negative results and were not consistent.

Conclusion

Considering heterogeneity between SFUs pharmacogenomic studies regarding the method, sample size, population, gene/variant studied, and outcome and findings, these studies are not conclusive and need further studies.

Possible approaches to CYP2C9-guided prescription of sulfonylureas in Russia

AIM

To evaluate a possible role of CYP2C9 genotyping for sulfonylureas (SUs) prescription in Russia.

MATERIALS & METHODS

We have collected the current data on correlation between SUs pharmacodynamics and CYP2C9 polymorphisms. We have evaluated the frequency of CYP2C9 polymorphisms in Russia by reviewing the literature published from 2004 to 2015 on Russian CYP2C9.

RESULTS

The genotype *1/*1, which confers risk for treatment failure, has a higher frequency (81.92%) in the non-Caucasians than that (64.92%) in the Caucasians. The Caucasians have a frequency (3.58%) of the poor metabolizers (*2/*2, *2/*3 and *3/*3) eight-times higher than that (0.44%) in the non-Caucasians, predisposing an increased risk of hypoglycemia.

CONCLUSION

Considering the received data and the existed knowledge on CYP2C9 influence on SUs pharmacokinetics and pharmacodynamics, we propose a possible approach to CYP2C9-guided SUs prescription for Russians.