The clinical pharmacogenomics implementation consortium: CPIC guideline for SLCO1B1 and simvastatin-induced myopathy

Clin Pharmacol Ther. 2012 Jul;92(1):112-7. doi: 10.1038/clpt.2012.57. Epub 2012 May 23.

Abstract

Cholesterol reduction from statin therapy has been one of the greatest public health successes in modern medicine. Simvastatin is among the most commonly used prescription medications. A non-synonymous coding single-nucleotide polymorphism (SNP), rs4149056, in SLCO1B1 markedly increases systemic exposure to simvastatin and the risk of muscle toxicity. This guideline explores the relationship between rs4149056 (c.521T>C, p.V174A) and clinical outcome for all statins. The strength of the evidence is high for myopathy with simvastatin. We limit our recommendations accordingly.

Publication types

  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drug Prescriptions
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / pharmacokinetics
  • Liver-Specific Organic Anion Transporter 1
  • Muscular Diseases* / chemically induced
  • Muscular Diseases* / genetics
  • Organic Anion Transporters / genetics*
  • Pharmacogenetics
  • Polymorphism, Single Nucleotide*
  • Precision Medicine
  • Risk Assessment
  • Risk Factors
  • Simvastatin* / administration & dosage
  • Simvastatin* / adverse effects
  • Simvastatin* / pharmacokinetics

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Liver-Specific Organic Anion Transporter 1
  • Organic Anion Transporters
  • SLCO1B1 protein, human
  • Simvastatin