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February 11, 2026Pharmacotherapy The Journal of Human Pharmacology and Drug TherapyOpen Access

Cohort Study to Determine the Impact of CYP3A5 Genotype on Tacrolimus Dosing Requirements and Trough Concentrations in Heart Transplant Recipients

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Authors

YWYanting WuMEMichael T. EadonLSL. Schenkelberg

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Overview

Cohort study demonstrates CYP3A5 genotype influences tacrolimus dosing in heart transplant recipients, suggesting personalized dosing strategies.

Key Points

  • This study investigates how CYP3A5 expresser status affects tacrolimus dosing and trough concentrations in heart transplant recipients.
  • Retrospective cohort analysis of tacrolimus doses and concentrations in heart transplant recipients
  • Evaluation of CYP3A5 genotype, concomitant medications, and biochemical data
  • Comparison of time to therapeutic trough concentrations based on CYP3A5 expression status
  • Stepwise multiple regression analysis to consider potential covariates
  • CYP3A5 expressers required longer to achieve therapeutic trough concentrations (median 14 days) compared to nonexpressers (7.5 days, p = 0.0073)
  • Expressers needed nearly double the tacrolimus dose (10 mg/day) to reach target concentrations compared to nonexpressers (5 mg/day, p = 0.0019)
  • Dose-adjusted tacrolimus trough concentration (C0/D) was nearly 2-fold higher in nonexpressers (2.0 ng/(mL*mg)) than expressers (1.1 ng/(mL*mg), p = 0.0015)

Cite This Study

Wu et al. (2026) studied this question.

synapsesocial.com/papers/698c1bcd267fb587c655db8bhttps://doi.org/10.1002/phar.70116
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impact of cytochrome P450 3A5 expression on clinical outcomes in renal transplant recipients receiving tacrolimus-based immunosuppression2025 · 2 citations
  2. 2Early CYP3A5 Genotype-Based Adjustment of Tacrolimus Dosage Reduces Risk of De Novo Donor-Specific HLA Antibodies and Rejection among CYP3A5-Expressing Renal Transplant Patients2024 · 4 citations
  3. 3CYP3A5 genotyping-guided dosing versus weight-based dosing in a multi-ethnic population of kidney transplant recipients2025
  4. 4Pharmacogenetics Approach for Personalized Tacrolimus Dosing in Heart Transplantation: A Case Report and Literature Review2025
  5. 5Impact of CYP3A5 Gene Polymorphisms on Tacrolimus Pharmacokinetics and Renal Allograft Rejection in Kidney Transplant Recipients: A Meta-Analysis Across Ethnic Populations2025