Key result
CYP2C9*2 and CYP2C9*3 alleles show no link to sulfonylurea dosing or time to stable dose.
Why the study?
The effect of CYP2C9*2 and CYP2C9*3 alleles on prescribed dose and time-to-stable dose of sulfonylureas in patients with Type 2 diabetes mellitus was unclear.
Does the presence of CYP2C9*2 and CYP2C9*3 alleles affect the prescribed dose and time-to-stable dose of sulfonylureas in primary care patients with Type 2 diabetes mellitus?
Observational (n=207)
Yes
Does the presence of CYP2C9*2 and CYP2C9*3 alleles affect the prescribed dose and time-to-stable dose of sulfonylureas in primary care patients with Type 2 diabetes mellitus?
Genotyping for CYP2C9*2 and CYP2C9*3 alleles does not appear to have clinical implications for dosing sulfonylureas in primary care patients with Type 2 diabetes mellitus.
CYP2C9 genotyping shows no sulfonylurea dosing effect in primary care; hypothesis-generating and should not yet change practice.
AIMS: Sulfonylureas are mainly metabolized by the enzyme CYP2C9. Two allelic variants, CYP2C9*2 and CYP2C9*3, result in decreased metabolic capacity and have been associated with elevated sulfonylurea serum levels. However, most of the available data originates from pharmacokinetic analyses performed in healthy individuals. In this study, the effect of CYP2C9*2 and CYP2C9*3 alleles on prescribed dose and time-to-stable dose of sulfonylureas was investigated. MATERIALS & METHODS: A group of 207 incident sulfonylurea users treated in four university affiliated primary care centers were identified. The effect of the CYP2C9*2 and CYP2C9*3 alleles on prescribed dose and time-to-stable dose was then assessed. RESULTS: No significant effects of the CYP2C9*2 and CYP2C9*3 alleles were found. However, a trend towards a lower stable glimepiride dose for carriers of the CYP2C9*3 allele was observed. CONCLUSION: Genotyping for the CYP2C9*2 and CYP2C9*3 alleles currently appears to have no clinical implications for dosing of sulfonylureas in primary care patients with Type 2 diabetes mellitus.
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Swen et al. (2010) conducted an observational in Type 2 Diabetes Mellitus (n=207). CYP2C9*2 and CYP2C9*3 alleles vs. Non-carriers was evaluated on Prescribed dose and time-to-stable dose of sulfonylureas. CYP2C9*2 and CYP2C9*3 alleles had no significant effect on the prescribed dose or time-to-stable dose of sulfonylureas in primary care patients with Type 2 diabetes mellitus.
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