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CYP2C19*2 Polymorphism Is Associated with Impaired Oral Clearance of Gliclazide in Healthy Chinese

Authors Chow E, Poon EWM, Fok BSP, Chan JCN, Tomlinson B

Received 6 August 2019

Accepted for publication 28 November 2019

Published 3 January 2020 Volume 2019:12 Pages 397—401


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Martin Bluth

Elaine Chow,1,2 Emily WM Poon,2 Benny SP Fok,1 Juliana CN Chan,2 Brian Tomlinson1–3

1Phase 1 Clinical Trial Centre, The Chinese University of Hong Kong, Hong Kong; 2Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; 3Faculty of Medicine, Macau University of Science & Technology, Taipa, Macau

Correspondence: Elaine Chow Email

Background: Previous studies suggest gliclazide is metabolised primarily by CYP2C19 rather than CYP2C9, unlike other sulphonylureas. CYP2C19 *2 and *3 polymorphisms are more common in Asians.
Methods: We investigated the effect of CYP2C19 polymorphisms on gliclazide pharmacokinetics in 15 healthy male Chinese subjects after a single 80mg oral dose.
Results: In CYP2C19 poor metabolisers (*2/*2, n=4), plasma area-under-the-curve was higher by nearly two-fold compared with intermediate metabolisers (*2 and *3 heterozygotes, n=7) and extensive metabolisers (*1/*1, n=4) (p<0.001). Apparent oral clearance was mean (SD) 0.70 (0.12), 1.22 (0.22) and 1.52 (0.47) mL/min/kg in poor, intermediate and extensive metabolisers, respectively (p = 0.005).
Conclusion: CYP2C19*2 polymorphism is associated with increased total gliclazide concentration and reduced oral clearance. Pharmacogenetic studies are warranted on the impact of CYP2C19 polymorphisms on treatment response and hypoglycaemia.

Keywords: gliclazide, pharmacogenetics, CYP2C19

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