Background: New Oral Anticoagulants (NOACs) are effective and widely used to prevent and treat
thromboembolic diseases, but the response to NOACs differs according to ABCB1 genotypes.
Objective: We investigated the effects of ABCB1 genotypes on the pharmacokinetics and clinical outcomes of
Methods: We searched PubMed, Embase, and the Cochrane Library for studies on ABCB1 genotypes published
from the inception of these databases until May 23, 2018. The Weighted Mean Difference (WMD) and Odds
Ratio (OR) with 95% Confidence Interval (CI) were calculated for continuous and dichotomous data, respectively.
Summary results were calculated using a random effects model.
Results: Ten studies involving 2609 individuals were included in the systematic review, and three studies involving
535 individuals were included in the meta-analysis. Overall, four ABCB1 single-nucleotide polymorphisms
were identified in the review. Carriers of the ABCB1 rs1045642 CC genotype had lower maximum plasma concentration
(Cmax) than those of TT (WMD = −16.99 ng/mL; 95% CI = −33.39 to −0.59; P = 0.04), and carriers of
the rs2032582 GG genotype showed lower Cmax than those of the A/T allele (WMD = −19.21 ng/mL; 95% CI =
−36.62 to −1.80; P = 0.03). Carriers of the rs1045642 CC genotype showed lower area under the curve from time
0 to infinity (AUC0–∞) than those of the T allele (WMD = −78.58 ng·h/mL; 95% CI = −151.14 to −6.01; P =
0.03). ABCB1 rs4148738 genotypes did not affect the risks of ischemic stroke or systemic embolism (OR =
0.88), ischemic events (OR = 0.98), bleeding (OR = 0.94), major bleeding (OR = 1.14), or minor bleeding (OR =
0.94) in patients treated with dabigatran.
Conclusion: Cmax was lower in carriers of ABCB1 rs1045642 CC than in those of TT and in carriers of rs2032582
GG than in those of the A/T allele, and AUC0–∞ was lower in carriers of rs1045642 CC than in those of TT. Conversely,
ABCB1 rs4148738 genotypes did not affect primary clinical endpoints in dabigatran-administered patients.
Future studies should analyze the relationships of ABCB1 genotypes with the pharmacokinetics and clinical
outcomes of specific NOACs.