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
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Practice Guideline
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Drug Prescriptions
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors* / administration & dosage
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Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
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Hydroxymethylglutaryl-CoA Reductase Inhibitors* / pharmacokinetics
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Liver-Specific Organic Anion Transporter 1
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Muscular Diseases* / chemically induced
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Muscular Diseases* / genetics
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Organic Anion Transporters / genetics*
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Pharmacogenetics
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Polymorphism, Single Nucleotide*
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Precision Medicine
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Risk Assessment
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Risk Factors
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Simvastatin* / administration & dosage
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Simvastatin* / adverse effects
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Simvastatin* / pharmacokinetics
Substances
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Liver-Specific Organic Anion Transporter 1
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Organic Anion Transporters
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SLCO1B1 protein, human
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Simvastatin