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MPA is the active metabolite formed from the biotransformation of the prodrugs mycophenolate mofetil (MMF) or enteric\u2010coated mycophenolate sodium (EC\u2010MPS). MPA exerts its therapeutic effects by inhibiting guanosine nucleotide synthesis in lymphocytes. Through this inhibition, cell and humoral immunity is suppressed, resulting in a reduction of cytotoxicity and inflammation. Systemic exposure to MPA is influenced by a complex pharmacokinetic pathway, which involves various drug\u2010metabolizing enzymes (DMEs) and transporters. Substantial interindividual variability exists in MPA exposure, efficacy, and adverse effects. Genetic polymorphisms in the genes encoding DMEs and transporters have been reported to influence this observed variability; however, evidence remains inconsistent and is largely derived from non\u2010African populations. African populations exhibit high levels of genetic diversity, and their underrepresentation in pharmacogenetic studies may hinder the identification of important variants influencing MPA disposition and clinical outcomes. This review evaluates the genes that have been reported to affect MPA exposure as well as highlights conflicting results on the role of these pharmacogenetic variants in different populations. The review highlights the lack of data on African populations and provides justification for their inclusion in the study of MPA pharmacogenetics.<\/jats:p>","DOI":"10.1111\/cts.70599","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:21:54Z","timestamp":1778836914000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacogenetics of Mycophenolic Acid in Patients of African Descent: Underrepresentation of African Data"],"prefix":"10.1111","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5358-9910","authenticated-orcid":false,"given":"Migael","family":"Mouton","sequence":"first","affiliation":[{"name":"Division of Human Genetics, Department of Pathology and Institute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences University of Cape Town  Cape Town South Africa"},{"name":"SAMRC\/UCT Platform for Pharmacogenomics Research and 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