AUTHOR=Kawaguchi-Suzuki Marina , Cusi Kenneth , Bril Fernando , Gong Yan , Langaee Taimour , Frye Reginald F. 

TITLE=A Genetic Score Associates With Pioglitazone Response in Patients With Non-alcoholic Steatohepatitis

JOURNAL=Frontiers in Pharmacology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2018.00752

DOI=10.3389/fphar.2018.00752

ISSN=1663-9812

ABSTRACT=<p>Pioglitazone is used effectively to treat non-alcoholic steatohepatitis (NASH), but there is marked variability in response. This study examined whether genetic variation contributes to pioglitazone response variability in patients with NASH. This genetic substudy includes 55 participants of a randomized controlled trial designed to determine the efficacy of long-term pioglitazone treatment in patients with NASH. The primary outcome of the clinical trial was defined as ≥2-point reduction in the non-alcoholic fatty liver disease activity score (NAS). In this substudy, single nucleotide polymorphisms (SNPs) in putative candidate genes were tested for association with primary and secondary outcomes. A genetic response score was constructed based on the sum of response alleles for selected genes. The genetic response score was significantly associated with achievement of the primary outcome (odds ratio 1.74; 95% CI 1.27–2.54; <italic>p</italic> = 0.0015). <italic>ADORA1</italic> rs903361 associated with resolution of NASH (<italic>p</italic> = 0.0005) and change in the ballooning score among Caucasian and Hispanic patients (<italic>p</italic> = 0.0005). <italic>LPL</italic> rs10099160 was significantly associated with change in ALT (<italic>p</italic> = 0.0005). The <italic>CYP2C8<sup>∗</sup>3</italic> allele, which confers faster pioglitazone clearance in allele carriers, was associated with change in fibrosis score (<italic>p</italic> = 0.026). This study identified key genetic factors that explain some of the inter-individual variability in response to pioglitazone among patients with NASH.</p>