Evidence map›Paper›PMID 40974042›Full record

GuidelineClinical pharmacology and therapeutics2025

Clinical Pharmacogenetics Implementation Consortium Guideline for NAT2 Genotype and Hydralazine Therapy.

Michael T Eadon, David W Hein, Michael A Andersen, Arlene B Chapman, Rhonda M Cooper-DeHoff, Zeruesenay Desta, Julio D Duarte, Amanda L Elchynski, Andrea Gaedigk, Seth E Karol and 9 more

Abstract readPractice Guideline
In one paragraph

Guideline in Clinical pharmacology and therapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Impact ofBiomolecules · 2026
    Article
  4. PharmVar GeneFocus: NAT2-Genetic Variation and Updated Nomenclature.Clinical pharmacology and therapeutics · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Michael T EadonDivision of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0000-0003-3066-2876
David W HeinDepartment of Pharmacology and Toxicology, University of Louisville School of Medicine, Louisville, Kentucky, USA.ORCID 0000-0003-3261-9775
Michael A AndersenDepartment of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.ORCID 0000-0001-9729-9974
Arlene B ChapmanDepartment of Medicine, University of Chicago, Chicago, Illinois, USA.ORCID 0000-0003-4538-4565
Rhonda M Cooper-DeHoffDepartment of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida College of Pharmacy, Gainesville, Florida, USA.ORCID 0000-0002-5198-130X
Zeruesenay DestaDivision of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana, USA.ORCID 0009-0001-1513-1295
Julio D DuarteDepartment of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida College of Pharmacy, Gainesville, Florida, USA.ORCID 0000-0001-9766-4038
Amanda L ElchynskiDepartment of Pharmacy, Arkansas Children's Hospital, Little Rock, Arkansas, USA.ORCID 0000-0002-4020-7052
Andrea GaedigkDivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Research Institute and School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.ORCID 0000-0001-6968-1893
Seth E KarolDepartment of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.ORCID 0000-0001-8113-8180
Nita A LimdiDepartment of Neurology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.ORCID 0000-0002-4672-8406
Christelle LteifDepartment of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida College of Pharmacy, Gainesville, Florida, USA.ORCID 0000-0002-0468-8936
Laura SosinskiWalgreens Specialty, Indianapolis, Indiana, USA.
Pablo ZubiaurDepartment of Clinical Pharmacology, Hospital Universitario de la Princesa, Instituto Teófilo Hernando, Universidad Autónoma de Madrid (UAM), Instituto de Investigación Sanitaria La Princesa (IP), Madrid, Spain.ORCID 0000-0002-6150-4320
Michelle Whirl-CarrilloDepartment of Biomedical Data Science, Stanford University, Stanford, California, USA.ORCID 0000-0003-2414-9312
Teri E KleinDepartment of Biomedical Data Science, Stanford University, Stanford, California, USA.ORCID 0000-0001-5527-6475
Kelly E CaudleDepartment of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.ORCID 0000-0002-5663-3793
Roseann S DonnellyDepartment of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.ORCID 0000-0001-7550-042X
José A G AgúndezInstitute of Molecular Pathology Biomarkers, Universidad de Extremadura, Cáceres, Spain.ORCID 0000-0001-6895-9160

Funding

Role of oxidized linoleic acid metabolites in the pathogenesis of alcoholic liver diseaseP20GM113226 · NIGMS · UNIVERSITY OF LOUISVILLE · PI ZHANG, XIANG · 2016 to 2025
$24.1M
Superfund Training CoreP42ES023716 · NIEHS · UNIVERSITY OF LOUISVILLE · PI HEIN, DAVID W · 2017 to 2025
$18.1M
University of Louisville Center for Integrative Environmental Health SciencesP30ES030283 · NIEHS · UNIVERSITY OF LOUISVILLE · PI Amanda Jo LeBlanc · 2020 to 2026
$10.0M
PharmGKB: pharmacogenomics discovery and implementationU24HG010615 · NHGRI · STANFORD UNIVERSITY · PI TERI Ellen KLEIN, Michelle Whirl-Carrillo · 2020 to 2026
$9.5M
Indiana University Comprehensive Training in Clinical PharmacologyT32GM008425 · NIGMS · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI Zeruesenay Desta, Michael Thomas Eadon · 1992 to 2026
$7.7M
UOFL ENVIRONMENTAL HEALTH SCIENCES TRAINING PROGRAMT32ES011564 · NIEHS · UNIVERSITY OF LOUISVILLE · PI David W Hein, John Pierce Wise · 2004 to 2026
$7.1M
Clinical Implementation Resources for Pharmacogenomics (CIRP)U24HG013077 · NHGRI · STANFORD UNIVERSITY · PI CAUDLE, KELLY E., KLEIN, TERI ELLEN · 2023 to 2025
$4.4M
Preemptive pharmacogenetic testing in medically underserved populationsR01HG011800 · NHGRI · UNIVERSITY OF FLORIDA · PI Julio David Duarte · 2021 to 2026
$3.9M
Drug-gene-nutraceutical interactions of cannabidiolR01AT011463 · NCCIH · INDIANA UNIVERSITY INDIANAPOLIS · PI Michael Thomas Eadon · 2022 to 2026
$2.9M
Genomic and drug-drug interaction mechanisms of interindividual variability in drug dispositionR35GM145383 · NIGMS · INDIANA UNIVERSITY INDIANAPOLIS · PI Zeruesenay Desta · 2022 to 2026
$2.0M
Clinical Expansion of Precision Medicine in the Emergency DepartmentR01HG013416 · NHGRI · UNIVERSITY OF FLORIDA · PI Julio David Duarte, Sophia Sheikh · 2024 to 2026
$1.3M
Hypertension Intervention to Reduce Osteonecrosis in Children with Acute Lymphoblastic LeukemiaK08CA250418 · NCI · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI KAROL, SETH EVAN · 2020 to 2024
$1.1M
ALSACNational Institutes of Health (NIH) P20-GM113226National Institutes of Health (NIH) P30-ES030283National Institutes of Health (NIH) P42-ES023716National Institutes of Health (NIH) T32-ES011564National Institutes of Health (NIH) U24HG010615National Institutes of Health (NIH) U24HG013077NCCIH NIH HHS R01 AT011463NCI NIH HHS K08 CA250418NHGRI NIH HHS R01 HG011800NHGRI NIH HHS R01HG011800NHGRI NIH HHS R01 HG013416NHGRI NIH HHS R01HG013416NHGRI NIH HHS U24 HG010615NHGRI NIH HHS U24 HG013077NIC K08-CA250418NIEHS NIH HHS P30 ES030283NIEHS NIH HHS P42 ES023716NIEHS NIH HHS T32 ES011564NIGMS NIH HHS P20 GM113226NIGMS NIH HHS R35 GM145383NIGMS NIH HHS R3-5GM145383NIGMS NIH HHS T32 GM008425
6 · The paper itself

Abstract

Hydralazine is a vasodilator typically used in the treatment of resistant hypertension and heart failure. N-acetyltransferase 2 (NAT2) catalyzes the metabolism of hydralazine into inactive metabolites. NAT2 poor metabolizers (historically referred to as "slow acetylators") are predicted to have increased plasma hydralazine concentrations compared with NAT2 rapid and intermediate metabolizers (historically referred to as "rapid acetylators" and "intermediate acetylators," respectively), which may lead to both increased clinical efficacy and adverse effects, including drug-induced systemic lupus erythematosus. This guideline summarizes the evidence from the literature relevant to NAT2/hydralazine and provides recommendations for hydralazine prescribing based on NAT2 genotype-predicted acetylator phenotype (updates at www.cpicpgx.org).

Indexed as

Antihypertensive AgentsArylamine N-AcetyltransferaseHydralazinePharmacogeneticsVasodilator AgentsGenotypeHeart FailureHumansHypertensionPhenotypeAntihypertensive AgentsArylamine N-AcetyltransferaseHydralazineNAT2 protein, humanVasodilator Agents

Identifiers

PMID40974042
PMCPMC12641075

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.