SLCO1B1 and ABCG2 genotype-informed phenotypes are related to variation in ramipril exposure

Ramipril is an angiotensin-converting enzyme inhibitor used for hypertension and heart failure management. To date, scarce literature is available on pharmacogenetic associations affecting ramipril. The goal of this study was to investigate the effect of 120 genetic variants in 34 pharmacogenes (i.e...

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Bibliographic Details
Authors: Abbes, Houwaida; Zubiaur Precioso, Pablo; Soria Chacartegui, Paula; Torre Cruz, Tamara de la; Villapalos-García, Gonzalo; Candau Díaz, Carmen; Rodríguez Lopez, Andrea; González Iglesias, Eva; Aldama Martín, Marina; Navares-Gómez, Marcos; Omezzine, Asma; Ochoa Mazarro, María Dolores; Abad Santos, Francisco
Format: Article
Publication date:2024
Country:España
Institution:Universidad Autónoma de Madrid
Repository:Biblos-e Archivo. Repositorio Institucional de la UAM
Language:English
OAI Identifier:oai:repositorio.uam.es:10486/714109
Online Access:http://hdl.handle.net/10486/714109
https://dx.doi.org/10.1111/bcpt.14046
Access Level:Open access
Keyword:ABCG2
SLCO1B1
Pharmacogenetics
Pharmacokinetics
Ramipril
Farmacia
Description
Summary:Ramipril is an angiotensin-converting enzyme inhibitor used for hypertension and heart failure management. To date, scarce literature is available on pharmacogenetic associations affecting ramipril. The goal of this study was to investigate the effect of 120 genetic variants in 34 pharmacogenes (i.e., genes encoding for enzymes like CYPs or UGTs and transporters like ABC or SLC) on ramipril pharmacokinetic variability and adverse drug reaction (ADR) incidence. Twenty-nine healthy volunteers who had participated in a single-dose bioequivalence clinical trial of two formulations of ramipril were recruited. A univariate and multivariate analysis searching for associations between genetic variants and ramipril pharmacokinetics was performed. SLCO1B1 and ABCG2 genotype-informed phenotypes strongly predicted ramipril exposure. Volunteers with the SLCO1B1 decreased function (DF) phenotype presented around 1.7-fold higher dose/weight-corrected area under the curve (AUC/DW) than volunteers with the normal function (NF) phenotype (univariate p-value [puv] < 0.001, multivariate p-value [pmv] < 0.001, β = 0.533, R2 = 0.648). Similarly, volunteers with ABCG2 DF + poor function (PF) phenotypes presented around 1.6-fold higher AUC/DW than those with the NF phenotype (puv = 0.011, pmv < 0.001, β = 0.259, R2 = 0.648). Our results suggest that SLCO1B1 and ABCG2 are important transporters to ramipril pharmacokinetics, and their genetic variation strongly alters its pharmacokinetics. Further studies are required to confirm these associations and their clinical relevance