Variants in ADRB1 and CYP2C9: Association with Response to Atenolol and Losartan in Marfan Syndrome

To test whether variants in ADRB1 and CYP2C9 genes identify subgroups of individuals with differential response to treatment for Marfan syndrome through analysis of data from a large, randomized trial. In a subset of 250 white, non-Hispanic participants with Marfan syndrome in a prior randomized tri...

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Published in:The Journal of pediatrics 2020-07, Vol.222, p.213-220.e5
Main Authors: Van Driest, Sara L., Sleeper, Lynn A., Gelb, Bruce D., Morris, Shaine A., Dietz, Harry C., Forbus, Geoffrey A., Goldmuntz, Elizabeth, Hoskoppal, Arvind, James, Jeanne, Lee, Teresa M., Levine, Jami C., Li, Jennifer S., Loeys, Bart L., Markham, Larry W., Meester, Josephina A.N., Mital, Seema, Mosley, Jonathan D., Olson, Aaron K., Renard, Marjolijn, Shaffer, Christian M., Sharkey, Angela, Young, Luciana, Lacro, Ronald V., Roden, Dan M.
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Language:eng
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Summary:To test whether variants in ADRB1 and CYP2C9 genes identify subgroups of individuals with differential response to treatment for Marfan syndrome through analysis of data from a large, randomized trial. In a subset of 250 white, non-Hispanic participants with Marfan syndrome in a prior randomized trial of atenolol vs losartan, the common variants rs1801252 and rs1801253 in ADRB1 and rs1799853 and rs1057910 in CYP2C9 were analyzed. The primary outcome was baseline-adjusted annual rate of change in the maximum aortic root diameter z-score over 3 years, assessed using mixed effects models. Among 122 atenolol-assigned participants, the 70 with rs1801253 CC genotype had greater rate of improvement in aortic root z-score compared with 52 participants with CG or GG genotypes (Time × Genotype interaction P = .005, mean annual z-score change ± SE –0.20 ± 0.03 vs −0.09 ± 0.03). Among participants with the CC genotype in both treatment arms, those assigned to atenolol had greater rate of improvement compared with the 71 of the 121 assigned to losartan (interaction P = .002; −0.20 ± 0.02 vs −0.07 ± 0.02; P 
ISSN:0022-3476
1097-6833