Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

B Moriyama¹, A Owusu Obeng^{2

3

4}, J Barbarino⁵, S R Penzak⁶, S A Henning¹, S A Scott^{2

7}, Jag Agúndez⁸, J R Wingard⁹, H L McLeod¹⁰, T E Klein⁵, S J Cross^{11

12}, K E Caudle¹¹, T J Walsh¹³

Affiliations

¹ National Institutes of Health Clinical Center Pharmacy Department, Bethesda, Maryland, USA.
² The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Department of Pharmacy, The Mount Sinai Hospital, New York, New York, USA.
⁴ Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ Department of Genetics, Stanford University, Stanford, California, USA.
⁶ Department of Pharmacotherapy, University of North Texas, System College of Pharmacy, Fort Worth, Texas, USA.
⁷ Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁸ Department of Pharmacology, University of Extremadura, Cáceres, Spain.
⁹ University of Florida College of Medicine, Gainesville, Florida, USA.
¹⁰ DeBartolo Family Personalized Medicine Institute, Division of Population Sciences, Moffitt Cancer Center, Tampa, Florida, USA.
¹¹ Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹² Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis, Tennessee, USA.
¹³ Transplantation-Oncology Infectious Diseases Program, Departments of Medicine, Pediatrics, and Microbiology and Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, New York, USA.

PMID: 27981572
PMCID: PMC5474211
DOI: 10.1002/cpt.583

Practice Guideline

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

B Moriyama et al. Clin Pharmacol Ther. 2017 Jul.

. 2017 Jul;102(1):45-51.

doi: 10.1002/cpt.583. Epub 2017 Apr 18.

Authors

Affiliations

¹ National Institutes of Health Clinical Center Pharmacy Department, Bethesda, Maryland, USA.
² The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Department of Pharmacy, The Mount Sinai Hospital, New York, New York, USA.
⁴ Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ Department of Genetics, Stanford University, Stanford, California, USA.
⁶ Department of Pharmacotherapy, University of North Texas, System College of Pharmacy, Fort Worth, Texas, USA.
⁷ Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁸ Department of Pharmacology, University of Extremadura, Cáceres, Spain.
⁹ University of Florida College of Medicine, Gainesville, Florida, USA.
¹⁰ DeBartolo Family Personalized Medicine Institute, Division of Population Sciences, Moffitt Cancer Center, Tampa, Florida, USA.
¹¹ Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹² Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, Memphis, Tennessee, USA.
¹³ Transplantation-Oncology Infectious Diseases Program, Departments of Medicine, Pediatrics, and Microbiology and Infectious Diseases, Weill Cornell Medical Center of Cornell University, New York, New York, USA.

PMID: 27981572
PMCID: PMC5474211
DOI: 10.1002/cpt.583

Erratum in

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy.
[No authors listed] [No authors listed] Clin Pharmacol Ther. 2018 Feb;103(2):349. doi: 10.1002/cpt.953. Epub 2017 Dec 13. Clin Pharmacol Ther. 2018. PMID: 29313967 No abstract available.

Abstract

Voriconazole, a triazole antifungal agent, demonstrates wide interpatient variability in serum concentrations, due in part to variant CYP2C19 alleles. Individuals who are CYP2C19 ultrarapid metabolizers have decreased trough voriconazole concentrations, delaying achievement of target blood concentrations; whereas poor metabolizers have increased trough concentrations and are at increased risk of adverse drug events. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for the use of voriconazole for treatment based on CYP2C19 genotype (updates at https://cpicpgx.org/guidelines/ and www.pharmgkb.org).

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Comment in

Pharmacogenetics of Voriconazole: CYP2C19 but Also CYP3A4 Need to Be Genotyped.
Gautier-Veyret E, Fonrose X, Stanke-Labesque F. Gautier-Veyret E, et al. Clin Pharmacol Ther. 2017 Aug;102(2):189. doi: 10.1002/cpt.662. Epub 2017 May 26. Clin Pharmacol Ther. 2017. PMID: 28182291 No abstract available.
Response to "Pharmacogenetics of Voriconazole: CYP2C19 but Also CYP3A4 Need to Be Genotyped" - The Role of CYP3A4 and CYP3A5 Polymorphisms in Clinical Pharmacokinetics of Voriconazole.
Walsh TJ, Moriyama B, Penzak SR, Klein TE, Caudle KE. Walsh TJ, et al. Clin Pharmacol Ther. 2017 Aug;102(2):190. doi: 10.1002/cpt.681. Epub 2017 Apr 29. Clin Pharmacol Ther. 2017. PMID: 28455946 No abstract available.
Impact of CYP3A4 Genotype on Voriconazole Exposure.
Duflot T, Schrapp A, Bellien J, Lamoureux F. Duflot T, et al. Clin Pharmacol Ther. 2018 Feb;103(2):185-186. doi: 10.1002/cpt.809. Epub 2017 Aug 29. Clin Pharmacol Ther. 2018. PMID: 28786228 No abstract available.

References

1. Scott SA, et al. PharmGKB summary: very important pharmacogene information for cytochrome P450, family 2, subfamily C, polypeptide 19. Pharmacogenet Genomics. 2012;22:159–165. - PMC - PubMed
1. Gene Reference Materials for CYP2C19. [Accessed September 16 2016]; < https://www.pharmgkb.org/page/cyp2c19RefMaterials>.
1. Hicks JK, et al. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants. Clinical pharmacology and therapeutics. 2013;93:402–408. - PMC - PubMed
1. Scott SA, et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clinical pharmacology and therapeutics. 2013;94:317–323. - PMC - PubMed
1. Sibbing D, et al. Cytochrome 2C19*17 allelic variant, platelet aggregation, bleeding events, and stent thrombosis in clopidogrel-treated patients with coronary stent placement. Circulation. 2010;121:512–518. - PubMed

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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

Affiliations

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guidelines for CYP2C19 and Voriconazole Therapy

Authors

Affiliations

Erratum in

Abstract

Comment in

References

Publication types

MeSH terms

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Grants and funding

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Full Text Sources

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Medical