临床药物遗传学实施联盟指南（CPIC）：CYP2C9 与非甾体类抗炎药。
Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs.
机构信息
Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Division of Pharmacotherapy and Experimental Therapeutics, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
出版信息
Clin Pharmacol Ther. 2020 Aug;108(2):191-200. doi: 10.1002/cpt.1830. Epub 2020 Apr 28.
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics due to their lack of addictive potential. However, NSAIDs have the potential to cause serious gastrointestinal, renal, and cardiovascular adverse events. CYP2C9 polymorphisms influence metabolism and clearance of several drugs in this class, thereby affecting drug exposure and potentially safety. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for NSAIDs based on CYP2C9 genotype (updates at www.cpicpgx.org).
摘要
非甾体抗炎药（NSAIDs）由于缺乏成瘾性而成为最常用的镇痛药之一。然而，NSAIDs 有可能引起严重的胃肠道、肾脏和心血管不良事件。CYP2C9 多态性影响该类药物的代谢和清除，从而影响药物暴露和潜在的安全性。我们总结了来自已发表文献的证据，支持这些关联，并根据 CYP2C9 基因型为 NSAIDs 提供治疗建议（www.cpicpgx.org 更新）。
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本文引用的文献
1
Retained duplications and deletions of CYP2C genes among primates.
Mol Phylogenet Evol. 2018 Aug;125:204-212. doi: 10.1016/j.ympev.2018.03.037. Epub 2018 Apr 6.
2
Cyclooxygenase Inhibition: Pain, Inflammation, and the Cardiovascular System.
Clin Pharmacol Ther. 2017 Oct;102(4):611-622. doi: 10.1002/cpt.794. Epub 2017 Aug 17.
3
Widespread Use of Prescription Nonsteroidal Anti-Inflammatory Drugs Among U.S. Army Active Duty Soldiers.
Mil Med. 2017 Mar;182(3):e1709-e1712. doi: 10.7205/MILMED-D-16-00183.
4
Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for Pharmacogenetics-Guided Warfarin Dosing: 2017 Update.
Clin Pharmacol Ther. 2017 Sep;102(3):397-404. doi: 10.1002/cpt.668. Epub 2017 Apr 4.
5
Effect of gender and CYP2C9 and CYP2C8 polymorphisms on the pharmacokinetics of ibuprofen enantiomers.
Pharmacogenomics. 2015;16(9):939-48. doi: 10.2217/pgs.15.40. Epub 2015 Jun 30.
6
CYP2C9 genotype vs. metabolic phenotype for individual drug dosing--a correlation analysis using flurbiprofen as probe drug.
PLoS One. 2015 Mar 16;10(3):e0120403. doi: 10.1371/journal.pone.0120403. eCollection 2015.
7
Effects of CYP2C9*1/*3 genotype on the pharmacokinetics of flurbiprofen in Korean subjects.
Arch Pharm Res. 2015 Jun;38(6):1232-7. doi: 10.1007/s12272-015-0580-0. Epub 2015 Feb 25.
8
Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing.
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9
Strongly increased exposure of meloxicam in CYP2C9*3/*3 individuals.
Pharmacogenet Genomics. 2014 Feb;24(2):113-7. doi: 10.1097/FPC.0000000000000025.
10
Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials.
Lancet. 2013 Aug 31;382(9894):769-79. doi: 10.1016/S0140-6736(13)60900-9. Epub 2013 May 30.
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