Influence of novel CYP2C‐haplotype on proton pump inhibitor pharmacokinetics in children

Author:

Kyler Kathryn E.12ORCID,Gaedigk Andrea23ORCID,Abdel‐Rahman Susan2ORCID,Staggs Vincent S.4ORCID,Pearce Robin E.23,Toren Paul3,Leeder J. Steven23ORCID,Shakhnovich Valentina23ORCID

Affiliation:

1. Division of Hospital Medicine Children's Mercy Kansas City Kansas City Missouri USA

2. School of Medicine University of Missouri‐Kansas City Kansas City Missouri USA

3. Division of Clinical Pharmacology, Toxicology & Therapeutic Innovation Children's Mercy Research Institute Kansas City Missouri USA

4. IDDI, Inc. (Formerly Biostatistics & Epidemiology Core, Children's Mercy Research Institute, Kansas City, Missouri) Raleigh North Carolina USA

Abstract

AbstractIn this brief report, we provide an analysis of the influence of a novel CYP2C haplotype (CYP2C:TG) on proton pump inhibitor (PPI) pharmacokinetics (PK) in children. The CYP2C:TG haplotype has been proposed to be associated with increased CYP2C19 activity. We sought to determine if this CYP2C:TG haplotype resulted in similar alterations in metabolism for proton pump inhibitors, which are primarily metabolized by CYP2C19. In a cohort of 41 children aged 6–21 participating in a PPI pharmacokinetic study, effects of the CYP2C:TG allele were assessed by fitting two linear regression models for each of the six PK outcomes assessed, the second of which accounted for the presence of the CYP2C:TG allele. The difference in R2 values between the two models was computed to quantify the variability in the outcome that could be accounted for by the CYP2C:TG allele after adjustment for the CYP2C19 genotype. We found the CYP2C:TG haplotype to have no measurable additive impact on CYP2C19‐mediated metabolism of PPIs in vivo in older children and adolescents. The findings of this study do not support the clinical utility of routine testing for the CYP2C:TG haplotype to guide PPI dose adjustments in children.

Funder

National Institute of Diabetes and Digestive and Kidney Diseases

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Wiley

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