Association of CYP2C19 polymorphism with cyclophosphamide-induced toxicity in systemic lupus erythematosus and lupus nephritis: A systematic review and meta-analysis.

This article focuses on the association between the CYP2C19*2 genetic polymorphism and cyclophosphamide (CYC)-induced toxicity in patients with systemic lupus erythematosus (SLE) and lupus nephritis (LN). A systematic review and meta-analysis of five studies involving diverse ethnic populations found that carriers of the CYP2C19*2 allele have a significantly reduced risk of CYC-related toxicity, with an odds ratio of 0.28, suggesting a protective effect likely due to decreased metabolic activation of CYC. Despite some concerns about confounding factors and variability in outcome measurement, the findings support the potential clinical utility of CYP2C19 genotyping to personalize CYC therapy and minimize adverse effects. The authors recommend larger, multiethnic studies with standardized toxicity assessments to validate these results and further explore pharmacogenetic markers in SLE and LN treatment.