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Effect of CYP2C9 polymorphisms on prescribed dose and time-to-stable dose of sulfonylureas in primary care patients with Type 2 diabetes mellitus

    Jesse J Swen

    Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands

    ,
    Judith AM Wessels

    Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands

    ,
    Annemarie Krabben

    Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands

    ,
    Willem JJ Assendelft

    Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands

    &
    Henk-Jan Guchelaar

    † Author for correspondence

    Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands.

    Published Online:https://doi.org/10.2217/pgs.10.121

    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.

    Papers of special note have been highlighted as: ▪ of interest

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