Meta-analysis reveals a lack of association between MRP2 C-24T genetic polymorphism and the pharmacokinetics of mycophenolic acid in adult renal transplant recipients

•We firstly assessed the effect of the multidrug resistance protein 2 (MRP2) C-24T polymorphism on the pharmacokinetics (PKs) and safety of mycophenolic acid (MPA) in the literature.•MRP2 C-24T polymorphism has no significant effect on the PKs of MPA in steady-state conditions or the safety of MPA in adult renal transplant recipients;•MRP2 C-24T polymorphism is not associated with the safety of MPA in adult renal transplant recipients;•Further large-scale, case-control studies with rigorous designs should be carried out to confirm these conclusions.

BackgroundRecent studies have shown that the multidrug resistance protein 2 (MRP2) C-24T genetic polymorphism is associated with the pharmacokinetics (PKs) of mycophenolic acid (MPA) in renal transplant recipients. However, published studies have reported inconsistent results. Therefore, a meta-analysis and systematic review were conducted to evaluate the effect of the MRP2 C-24T polymorphism on the PKs and safety of MPA in the literature.MethodsA comprehensive literature search was performed using the PubMed, Cochrane Library and Embase databases. Heterogeneity was assessed; forest plots were also used. In total, 10 studies with 1048 renal transplant recipients were included in our meta-analysis and systematic review.ResultsThe results showed that the MRP2 C-24T polymorphism was not associated with the PKs of MPA [AUC0-12/dose: SMD = − 0.103 (− 0.566, 0.361), P = 0.143] using the dominant model in our analysis, and a lack of correlation was found between the C-24T polymorphism and the occurrence of biopsy-proven acute rejection (BPAR) or MPA-related adverse events in the systematic review.ConclusionsIn conclusion, our meta-analysis and systematic review suggest that the MRP2 C-24T polymorphism has no significant effect on the PKs of MPA in steady-state conditions and is not associated with the safety of MPA in adult renal transplant recipients. Moreover, further large-scale, case-control studies with rigorous designs should be carried out to confirm these conclusions.

Graphical abstractDownload high-res image (138KB)Download full-size image