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The CYP3A4*22 allele affects the predictive value of a pharmacogenetic algorithm predicting tacrolimus predose concentrations.

The cytochrome P450 (CYP) 3A4*22 allelic status influences the pharmacokinetics of tacrolimus independently of an individual's CYP3A5 genotype. In their recent publication, Passey et al described an algorithm that predicts tacrolimus apparent clearance (CL/F) by taking into account the age and CYP3A5 genotype of a patient, time after kidney transplantation, whether the transplantation was performed at a steroid-sparing center or not and whether the patient was treated with a calcium channel blocker (CCB). However, as the effect of the CYP3A4*22 allele was only recently reported, these authors did not consider this variable as a potential predictive factor for tacrolimus CL/F.