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Published on: October 24, 2017
UGT polymorphisms and lamotrigine clearance during pregnancy.
Vaiva Petrenaite1, Inger Öhman2, Lena Ekström3
1Epilepsy Clinic, Department of Neurology, University Hospital of Copenhagen, Rigshospitalet-Blegdamsvej and Glostrup, Denmark.
Maternal UGT1A4 and UGT2B7 genetic variations, along with fetal sex, influence lamotrigine (LTG) clearance during pregnancy. Fetal sex significantly impacts LTG clearance changes throughout gestation.
Area of Science:
- Pharmacogenetics
- Reproductive Medicine
- Clinical Pharmacology
Background:
- Lamotrigine (LTG) is an antiepileptic drug commonly used during pregnancy.
- Changes in drug metabolism during pregnancy can affect therapeutic efficacy and safety.
- Maternal genetic factors and fetal characteristics may influence drug clearance.
Purpose of the Study:
- To investigate the impact of maternal UGT1A4 and UGT2B7 genetic polymorphisms on LTG clearance during pregnancy and postpartum.
- To assess the influence of fetal sex on LTG clearance changes throughout gestation.
Main Methods:
- Genotyping of UGT1A4 (142T>G, 70C>A) and UGT2B7 (802C>T) polymorphisms in 40 women with epilepsy on LTG.
- Retrospective analysis of LTG dosage and plasma levels across pregnancy trimesters and postpartum.
- Correlation of genetic data and fetal sex with LTG concentration-to-dose (C/D) ratio changes.
Main Results:
- LTG C/D ratio decreased significantly during pregnancy, ranging from -53% to -74% in the third trimester.
- UGT1A4 142T>G and UGT2B7 802C>T polymorphisms showed the most pronounced effect on LTG clearance.
- Women carrying a female fetus exhibited significantly greater reductions in LTG C/D ratio compared to those with a male fetus.
Conclusions:
- Maternal UGT1A4 and UGT2B7 genetic variations may modestly affect LTG clearance changes during pregnancy.
- Fetal sex is a significant factor influencing the alterations in LTG clearance throughout pregnancy.
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