Key result
ABCB1 rs1045642 wild homozygotes (AA) had significantly lower rivaroxaban concentrations compared to mutated homozygotes (CC) (SMD 0.516; 95% CI 0.115-0.917).
Why the study?
Pharmacogenetics may help decline the burden of rivaroxaban's ADRs, prompting an evaluation of genetic variants correlated with rivaroxaban exposure.
Do genetic variants in ABCB1 and APOB affect rivaroxaban concentrations and adverse drug reactions in patients taking rivaroxaban?
Meta-Analysis (n=4,721)
Do genetic variants in ABCB1 and APOB affect rivaroxaban concentrations and adverse drug reactions in patients taking rivaroxaban?
Standardized Mean Difference: 0.516 (95% CI 0.115–0.917)
The ABCB1 rs1045642 variant is a significant predictor of rivaroxaban metabolism and concentrations, suggesting a potential future role for pharmacogenetic testing to prevent adverse drug reactions.
ABCB1 variants may influence rivaroxaban exposure; leaves open whether pharmacogenetic testing should guide dosing.
Introduction: Pharmacogenetics is a potential approach that can be applied to decline the burden of rivaroxaban's ADRs. The current systematic review and meta-analysis aim to identify genetic variants correlated with rivaroxaban exposure and evaluate their importance. Methods: value was less than 0.1. Results: Data from ten studies (4721 participants) were analyzed in the current review. Qualitative synthesis from included studies found that two variants of ABCB1 (rs1045642 and rs2032582) and one variant of APOB (rs13306198) are potential contributors to rivaroxaban concentrations. Both wild homozygotes (AA) and heterozygotes (AC) of rs1045642 have significantly lower rivaroxaban concentrations compared to mutated homozygotes (CC) (SMD = 0.516, 95% CI: 0.115 to 0.917; SMD = 0.772, 95% CI: 0.088 to 1.455, respectively). Nevertheless, pooling unadjusted odds ratios did not yield a statistically significant correlation between rivaroxaban ADRs and genetic mutations. Conclusion: This study revealed that being an AC or CC for rs1045642 is attributed to a considerably higher rivaroxaban level in participants using rivaroxaban. That is to say, rs1045642 is a remarkable predictor of rivaroxaban metabolism. We concluded that identifying rs1045642 before drug administration might decrease ADRs although further studies adjusted for potential confounders are strongly suggested.
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Mardi et al. (2023) conducted a meta-analysis in Rivaroxaban adverse drug reactions (ADRs) (n=4,721). ABCB1 rs1045642 wild homozygotes (AA) vs. mutated homozygotes (CC) was evaluated on Rivaroxaban concentrations (SMD 0.516, 95% CI 0.115 to 0.917). ABCB1 rs1045642 wild homozygotes (AA) had significantly lower rivaroxaban concentrations compared to mutated homozygotes (CC) (SMD 0.516; 95% CI 0.115-0.917).
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