1
|
Mukonzo JK, Kengo A, Kutesa B, Nanzigu S, Pohanka A, McHugh TD, Zumla A, Aklillu E. Role of pharmacogenetics in rifampicin pharmacokinetics and the potential effect on TB–rifampicin sensitivity among Ugandan patients. Trans R Soc Trop Med Hyg 2019; 114:107-114. [DOI: 10.1093/trstmh/trz108] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/15/2019] [Accepted: 11/04/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Suboptimal anti-TB drugs exposure may cause multidrug-resistant TB. The role of African predominant SLCO1B1 variant alleles on rifampicin pharmacokinetics and the subsequent effect on the occurrence of Mycobacterium tuberculosis–rifampicin sensitivity needs to be defined. We describe the rifampicin population pharmacokinetics profile and investigate the relevance of SLCO1B1 genotypes to rifampicin pharmacokinetics and rifampicin-TB sensitivity status.
Methods
Fifty patients with TB (n=25 with rifampicin-resistant TB and n=25 with rifampicin-susceptible TB) were genotyped for SLOC1B1 rs4149032 (g.38664C>T), SLOC1B1*1B (c.388A>G) and SLOC1B1*5 (c.521 T>C). Steady state plasma rifampicin levels were determined among patients infected with rifampicin-sensitive TB. Data were analysed using NONMEM to estimate population rifampicin pharmacokinetics as well as the effect of SLOC1B1 genotypes on rifampicin pharmacokinetics and on rifampicin-TB sensitivity status.
Results
Overall allele frequencies of SLOC1B1 rs4149032, *1B and *5 were 0.66, 0.90 and 0.01, respectively. Median (IQR) Cmax and Tmax were 10.2 (8.1–12.5) mg/L and 1.7 (1.125–2.218) h, respectively. Twenty-four percent of patients exhibited Cmax below the recommended 8–24 mg/L range. SLOC1B1 genotypes, gender and age did not influence rifampicin pharmacokinetics or TB-rifampicin sensitivity.
Conclusions
Although SLOC1B1 genotype, age and gender do not influence either rifampicin pharmacokinetics or rifampicin-TB sensitivity status, one in every four Ugandan TB patients achieve subtherapeutic plasma rifampicin concentrations.
Collapse
Affiliation(s)
- Jackson K Mukonzo
- Department of Pharmacology & Therapeutics, Makerere University, P.O. Box 7072 Kampala, Uganda
| | - Allan Kengo
- Department of Pharmacology & Therapeutics, Makerere University, P.O. Box 7072 Kampala, Uganda
| | - Bisaso Kutesa
- Department of Pharmacology & Therapeutics, Makerere University, P.O. Box 7072 Kampala, Uganda
| | - Sarah Nanzigu
- Department of Pharmacology & Therapeutics, Makerere University, P.O. Box 7072 Kampala, Uganda
| | - Anton Pohanka
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge, SE-141 86 Stockholm, Sweden
| | - Timothy D McHugh
- Center for Clinical Microbiology, Division of Infection and Immunology, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF London, UK
| | - Alimuddin Zumla
- Center for Clinical Microbiology, Division of Infection and Immunology, University College London, Royal Free Hospital, Rowland Hill Street, NW3 2PF London, UK
- NIHR Biomedical Research Center at UCL Hospitals NHS Foundation Trust, 162 City Rd, EC1V 2PD London, Bungereza
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital-Huddinge, SE-141 86 Stockholm, Sweden
| |
Collapse
|
2
|
Baker SG, Xu JL, Hu P, Huang P. Vardeman, S. B. and Morris, M. D. (2013), "Majority Voting by Independent Classifiers can Increase Error Rates," The American Statistician, 67, 94-96: Comment by Baker, Xu, Hu, and Huang and Reply. AM STAT 2015; 68:125-126. [PMID: 26113746 DOI: 10.1080/00031305.2014.882867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | - Peng Huang
- Johns Hopkins Medical Institution, In the Public Domain
| |
Collapse
|