Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice
NSAIDs are the most commonly used drugs in clinical practice for pain relief in various diseases. To date, considerable scientific material has been accumulated on the pharmacogenetics of NSAIDs and the role of genetic factors that can influence the pharmacokinetics and pharmacodynamics of drugs, ch...
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| Format: | Article |
| Language: | Russian |
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Remedium Group LLC
2019-01-01
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| Series: | Медицинский совет |
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| Online Access: | https://www.med-sovet.pro/jour/article/view/2838 |
| _version_ | 1827961689037864960 |
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| author | M. V. Leonova E. E. Alimova |
| author_facet | M. V. Leonova E. E. Alimova |
| author_sort | M. V. Leonova |
| collection | DOAJ |
| description | NSAIDs are the most commonly used drugs in clinical practice for pain relief in various diseases. To date, considerable scientific material has been accumulated on the pharmacogenetics of NSAIDs and the role of genetic factors that can influence the pharmacokinetics and pharmacodynamics of drugs, changing the efficacy and toxicity profile. The most clinically significant changes in pharmacokinetics in carriers of slow alleles of CYP2C9*3 have been identified for celecoxib and flurbiprofen, which determines the need for testing and lowering of drug doses. Studies were carried out to study the role of polymorphism of the metabolizing enzymes CYP2C9, CYP2C8, UGT in the development of gastrotoxicity and gastrointestinal bleeding during application NSAIDs, as well as diclofenac’s hepatotoxicity. The association of «slow» alleles CYP2C8*3 and CYP2C9*2,*3 with the risk of gastrointestinal bleeding associated with NSAID use, which are substrates of CYP2C9 and CYP2C8, is shown. The effect of variants of alleles PTGS1 (gene COX-1) and PTGS2 (gene COX-2) on pharmacodynamics, efficacy and toxicity of NSAIDs, in particular, the severity of the analgesic effect and cardiotoxicity of the drugs, was studied. In this way, pharmacogenetic predictors of adverse effects that patients can experience, and the need for dose adjustment based on the patient’s genotype, or individualizing the choice of alternative NSAIDs to increase the effectiveness of analgesia, have been determined. |
| first_indexed | 2024-04-09T16:30:34Z |
| format | Article |
| id | doaj.art-4cbd90195d524d15b6a634af333d2046 |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:30:34Z |
| publishDate | 2019-01-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-4cbd90195d524d15b6a634af333d20462023-04-23T06:57:05ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902019-01-0102120420910.21518/2079-701X-2018-21-204-2092772Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practiceM. V. Leonova0E. E. Alimova1Federal State Budgetary Educational Institution of Higher Education “Pirogov Russian National Research Medical University” of the Ministry of Health of RussiaFederal State Budgetary Educational Institution of Higher Education “Pirogov Russian National Research Medical University” of the Ministry of Health of RussiaNSAIDs are the most commonly used drugs in clinical practice for pain relief in various diseases. To date, considerable scientific material has been accumulated on the pharmacogenetics of NSAIDs and the role of genetic factors that can influence the pharmacokinetics and pharmacodynamics of drugs, changing the efficacy and toxicity profile. The most clinically significant changes in pharmacokinetics in carriers of slow alleles of CYP2C9*3 have been identified for celecoxib and flurbiprofen, which determines the need for testing and lowering of drug doses. Studies were carried out to study the role of polymorphism of the metabolizing enzymes CYP2C9, CYP2C8, UGT in the development of gastrotoxicity and gastrointestinal bleeding during application NSAIDs, as well as diclofenac’s hepatotoxicity. The association of «slow» alleles CYP2C8*3 and CYP2C9*2,*3 with the risk of gastrointestinal bleeding associated with NSAID use, which are substrates of CYP2C9 and CYP2C8, is shown. The effect of variants of alleles PTGS1 (gene COX-1) and PTGS2 (gene COX-2) on pharmacodynamics, efficacy and toxicity of NSAIDs, in particular, the severity of the analgesic effect and cardiotoxicity of the drugs, was studied. In this way, pharmacogenetic predictors of adverse effects that patients can experience, and the need for dose adjustment based on the patient’s genotype, or individualizing the choice of alternative NSAIDs to increase the effectiveness of analgesia, have been determined.https://www.med-sovet.pro/jour/article/view/2838nsaidsgenetic polymorphismcyp2c9 isoformpharmacokineticspharmacodynamicsgastrotoxicitygastrointestinal bleedinghepatotoxicity |
| spellingShingle | M. V. Leonova E. E. Alimova Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice Медицинский совет nsaids genetic polymorphism cyp2c9 isoform pharmacokinetics pharmacodynamics gastrotoxicity gastrointestinal bleeding hepatotoxicity |
| title | Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice |
| title_full | Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice |
| title_fullStr | Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice |
| title_full_unstemmed | Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice |
| title_short | Pharmacogenetics of non-steroidal anti-inflammatory drugs: existing problems for clinical practice |
| title_sort | pharmacogenetics of non steroidal anti inflammatory drugs existing problems for clinical practice |
| topic | nsaids genetic polymorphism cyp2c9 isoform pharmacokinetics pharmacodynamics gastrotoxicity gastrointestinal bleeding hepatotoxicity |
| url | https://www.med-sovet.pro/jour/article/view/2838 |
| work_keys_str_mv | AT mvleonova pharmacogeneticsofnonsteroidalantiinflammatorydrugsexistingproblemsforclinicalpractice AT eealimova pharmacogeneticsofnonsteroidalantiinflammatorydrugsexistingproblemsforclinicalpractice |