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A simple method for determining acetylator phenotype using isoniazid.

A Hutchings, P A Routledge

    British Journal of Clinical Pharmacology
    |September 1, 1986
    PubMed
    Summary
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    A simplified acetylator phenotyping test using a single 3-hour blood sample for isoniazid (INH) and acetylisoniazid (Ac.INH) ratio is as reliable as the traditional 6-hour INH half-life method.

    Area of Science:

    • Pharmacology
    • Clinical Chemistry
    • Drug Metabolism

    Background:

    • Acetylator phenotype influences drug efficacy and toxicity.
    • Isoniazid (INH) is a key drug for tuberculosis treatment, and its metabolism varies among individuals.
    • Accurate phenotyping is crucial for personalized medicine.

    Purpose of the Study:

    • To compare the reliability of a rapid acetylator phenotyping method with the standard isoniazid (INH) half-life method.
    • To evaluate the diagnostic accuracy of the acetylisoniazid (Ac.INH)/isoniazid ratio in a single 3-hour sample.

    Main Methods:

    • Compared isoniazid (INH) half-life (6-hour sampling) with the ratio of acetylisoniazid (Ac.INH) to INH in 3-hour samples.
    • Phenotyped 32 subjects as fast or slow acetylators based on predefined thresholds.

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    Main Results:

    • Complete agreement was observed between the two methods in classifying subjects as fast or slow acetylators.
    • Fast acetylators: t1/2 < 130 min and Ac.INH/INH > 1.5.
    • Slow acetylators: t1/2 > 130 min and Ac.INH/INH < 1.5.

    Conclusions:

    • The single-sample acetylator phenotyping test is a reliable and efficient alternative to the time-consuming INH half-life method.
    • This rapid method can aid in clinical decision-making for isoniazid therapy.
    • Simplifies acetylator status determination in clinical practice.