January 28, 2019
Dr. Amy Pasternak
Congratulations to Dr. Amy Pasternak, who has won a 2019 American Association of Colleges of Pharmacy New Investigator Award.

Amy Pasternak, PharmD, clinical assistant professor of pharmacy and clinical pharmacist, Michigan Medicine, has won a 2019 American Association of Colleges of Pharmacy New Investigator Award. Sponsored by the American Association of Colleges of Pharmacy (AACP), the New Investigator Award provides start-up funding for the independent research programs of early-career pharmacy faculty. The $10,000 award will help fund Dr. Pasternak’s research on personalized medication for bone marrow transplant patients.

“This award will allow me to continue to explore the hypothesis that pharmacogenetic relationships differ between routes of drug administration for tacrolimus,” explains Dr. Pasternak. “This study will evaluate how CYP3A pharmacogenetic variants impact tacrolimus exposure after intravenous drug administration and compare whether the relationship differs from oral administration. A better understanding of this hypothesis will allow us to develop and subsequently translate improved genotype-guided dosing recommendations for all routes of tacrolimus therapy in future studies.” 

Tacrolimus is one of the most commonly prescribed medications after bone marrow transplant (BMT) to prevent graft versus host disease (GVHD). Tacrolimus requires daily monitoring for drug levels in the blood after transplant to make sure the drug level is safe and effective. Some patient characteristics, such as CYP3A5 genotype, can cause the patient to have lower drug levels at regular doses when the drug is administered as a pill. Lower drug levels increase the risk the patient will develop GVHD. This means the patient will need higher doses of the medication to achieve effective drug levels when taking tacrolimus in pill form and there are clinical guideline recommendations for personalized tacrolimus dose adjustments based on CYP3A5 genotype.

Many BMT patients are unable to take any medications in pill form after transplant and require tacrolimus infusions. “It is currently unknown whether CYP3A5 genotype has the same impact on tacrolimus blood levels when it is administered via infusion, but prior small studies have suggested the impact might be different,” says Dr. Pasternak.

The purpose of Dr. Pasternak’s study is to identify whether patients with specific CYP3A5 genotypes are at risk for low drug levels when receiving tacrolimus infusions after BMT. This study will also compare how the drug levels in patients with each CYP3A5 genotype compare between the tacrolimus infusion and the tacrolimus pill. This will help to determine whether the current guideline recommendations for personalized tacrolimus dosing are appropriate for the BMT patients who receive tacrolimus infusions. “If the recommendations are not appropriate for tacrolimus infusions, the data from this study will be used to develop preliminary dose recommendations for this tacrolimus formulation,” notes Dr. Pasternak.

Dr. Pasternak earned her PharmD from the Ohio Northern University Raabe College of Pharmacy in 2014. After graduation, she completed a PGY-1 Pharmacy Practice Residency at Cleveland Clinic Hillcrest Hospital in Mayfield Heights, OH. She then pursued specialty training in clinical pharmacogenetics as the PGY-2 Clinical Pharmacogenetics Residency at St. Jude Children’s Research Hospital in Memphis, TN and as a Clinical Pharmacy Translational Fellow at the University of Michigan College of Pharmacy. Dr. Pasternak joined the U-M faculty as a Clinical Assistant Professor in 2018. Her clinical practice is focused in the implementation of pharmacogenetics at Michigan Medicine and her research focuses on the discovery, validation, and translation of pharmacogenetic associations.