Pharmacogenomics of statins: understanding susceptibility to adverse effects

Statins are a cornerstone of the pharmacologic treatment and prevention of atherosclerotic cardiovascular disease. Atherosclerotic disease is a predominant cause of mortality and morbidity worldwide. Statins are among the most commonly prescribed classes of medications, and their prescribing indicat...

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Bibliographic Details
Published in:Pharmacogenomics and personalized medicine 2016-01, Vol.9, p.97-106
Main Authors: Kitzmiller, Joseph P, Mikulik, Eduard B, Dauki, Anees M, Murkherjee, Chandrama, Luzum, Jasmine A
Format: Article
Language:English
Subjects:
adverse effects
Atherosclerosis
Cardiovascular agents
Cardiovascular disease
Cardiovascular diseases
Cholesterol
Complications and side effects
Diabetes
Drug dosages
Drug therapy
Genes
Genomes
Health risk assessment
Lipids
Liver
Metabolites
muscle toxicity
myopathy
Patients
Pharmacogenetics
Pharmacogenomics
Pharmacy
Review
statin
Statins
Systematic review
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Summary:Statins are a cornerstone of the pharmacologic treatment and prevention of atherosclerotic cardiovascular disease. Atherosclerotic disease is a predominant cause of mortality and morbidity worldwide. Statins are among the most commonly prescribed classes of medications, and their prescribing indications and target patient populations have been significantly expanded in the official guidelines recently published by the American and European expert panels. Adverse effects of statin pharmacotherapy, however, result in significant cost and morbidity and can lead to nonadherence and discontinuation of therapy. Statin-associated muscle symptoms occur in ~10% of patients on statins and constitute the most commonly reported adverse effect associated with statin pharmacotherapy. Substantial clinical and nonclinical research effort has been dedicated to determining whether genetics can provide meaningful insight regarding an individual patient's risk of statin adverse effects. This contemporary review of the relevant clinical research on polymorphisms in several key genes that affect statin pharmacokinetics (eg, transporters and metabolizing enzymes), statin efficacy (eg, drug targets and pathways), and end-organ toxicity (eg, myopathy pathways) highlights several promising pharmacogenomic candidates. However, 521C is currently the only clinically relevant pharmacogenetic test regarding statin toxicity, and its relevance is limited to simvastatin myopathy.
ISSN:1178-7066
1178-7066
DOI:10.2147/PGPM.S86013