ISSN: 1859 - 2872
Application of a precision dosing tool integrating CYP3A5 genotype information for tacrolimus dose adjustment in kidney transplant recipients at 108 Military Central Hospital
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Abstract
Objective: To analyze the outcomes of pharmacist-led tacrolimus dosing interventions using a PopPK model integrated with CYP3A5 incorporating CYP3A5 genotypes in kidney transplant recipients. Subject and method: A descriptive, prospective, longitudinal study conducted through clinical pharmacy activities on 42 kidney transplant patients treated at the 108 Military Central Hospital from June 2024 to March 2025. Patients received pharmacist-guided recommendations for initial and adjusted tacrolimus doses, based on MIPD software integrating PopPK and CYP3A5 genotypes. Clinical and laboratory data were collected from medical records and treatment courses, and analyzed using RStudio. Result: A total of 36 out of 42 patients underwent CYP3A5 genotyping, with 55.56% carrying CYP3A513 and CYP3A511 alleles associated with tacrolimus metabolism. In the initial dosing phase, the proportion of patients with trough tacrolimus concentrations (C₀) above the therapeutic range was lower in the pharmacist-guided group compared to the non-guided group (26.93% vs. 50%). During the dose adjustment phase, the proportions of sub- and supra-therapeutic C₀ levels were significantly lower (p<0.01) in the guided group, while the proportion achieving target concentrations was markedly higher (31.53% vs. 11.54%). Furthermore, mean C₀ within the first 24 hours post-transplant was significantly higher in the pharmacist-guided group (7.5ng/mL vs. 6.1ng/mL, p<0.01). Conclusion: Pharmacist-guided tacrolimus dosing using a PopPK model integrated with CYP3A5 genotype information improved early attainment of therapeutic trough concentrations and optimized individualized dosing in kidney transplant recipients.
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References
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