Dampak Variasi Genetik terhadap Respon Terapi dan Potensi Hemolisis Anemia dari Penggunaan Primakuin melalui  Pendekatan Farmakogenetika

Rahman Sumani Sianu; Annisa Abdi Ghifari; Muhammad Ma’ruf; Eka Yuni Nur Jannah; Putri Ayu Lestari

doi:10.58996/hmj.v9i1.219

Rahman Sumani Sianu Program Studi Farmasi, Fakultas Farmasi dan Ilmu Kesehatan, Universitas Abdurrab, Riau, Indonesia https://orcid.org/0000-0002-2366-1288
Annisa Abdi Ghifari Program Studi Kedokteran, Fakultas Kedokteran, Universitas Abdurrab, Riau, Indonesia
Muhammad Ma’ruf Program Studi Farmasi Klinis dan Komunitas, Sekolah Tinggi Kesehatan ISFI (STIKES ISFI), Banjarmasin, Indonesia
Eka Yuni Nur Jannah Program Studi Ilmu Kesehatan, Fakultas Farmasi, Universitas Kartamulia, Indonesia
Putri Ayu Lestari Program Studi Ilmu Kesehatan, Fakultas Farmasi, Universitas Kartamulia, Indonesia

DOI: https://doi.org/10.58996/hmj.v9i1.219

Keywords: G6PD, Hemolytic, Malaria, Pharmacogenetics, Primaquine

Abstract

Primaquine is essential for radical cure of Plasmodium vivax malaria but poses hemolysis risk in G6PD-deficient individuals and shows variable therapeutic responses. Genetic polymorphisms in drug-metabolizing enzymes and transporters contribute to these inter-individual variations. To investigate genetic variants in G6PD, SLCO2B1, and MAOA genes that influence primaquine safety and efficacy, and to assess their clinical implications for personalized antimalarial therapy. Method the database used in this study is PhramGKB. Genetic polymorphisms in four candidate genes were analyzed for associations with hemolysis, anemia, therapeutic efficacy, and malaria recurrence. Statistical analyses determined the strength and significance of genotype-phenotype associations. Result G6PD variants rs1050828 and rs1050829 showed strong associations with hemolysis (p<0.01) and anemia (p=0.001). SLCO2B1 variant rs12422149 was associated with reduced chloroquine-primaquine efficacy (p=0.01). MAOA variant rs6323 increased malaria recurrence risk (p=0.03). Conclusion multiple genetic variants significantly impact primaquine safety and efficacy. These findings support pharmacogenetic-guided personalized antimalarial therapy to optimize outcomes and minimize adverse events, contributing to malaria elimination efforts.