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J. Pers. Med. 2012, 2(4), 158-174; doi:10.3390/jpm2040158

Statin Pharmacogenomics: Opportunities to Improve Patient Outcomes and Healthcare Costs with Genetic Testing

1,* , 2, 1, 3, 1, 4, 5 and 1
1 Generation Health, 130 Turner St., Waltham, MA 02453, USA 2 TESARO Inc., 1000 Winter St. Suite 3300, Waltham, MA 02451, USA 3 Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital, 1620 Tremont St., Suite 3030, Boston, MA 02120, USA 4 ZIOPHARM Oncology, Inc., 1 First Avenue, Parris Building, #34, Navy Yard Plaza, Boston, MA 02129, USA 5 CVS Caremark, One CVS Drive, Woonsocket, RI 02895, USA
* Author to whom correspondence should be addressed.
Received: 28 August 2012 / Revised: 1 October 2012 / Accepted: 10 October 2012 / Published: 17 October 2012
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HMG-CoA reductase inhibitors, commonly known as statins, are some of the most widely prescribed medications worldwide and have been shown to be effective at lowering cholesterol in numerous long-term prospective trials, yet there are significant limitations to their use. First, patients receiving statin therapy have relatively low levels of medication adherence compared with other drug classes. Next, numerous statin formulations are available, each with its own unique safety and efficacy profile, and it may be unclear to prescribers which treatment is optimal for their patients. Finally, statins have class-wide side effects of myopathy and rhabdomyolysis that have resulted in a product recall and dosage limitations. Recent evidence suggests that two genomic markers, KIF6 and SLCO1B1, may inform the therapy choice of patients initiating statins. Given the prevalence of statin usage, their potential health advantages and their overall cost to the healthcare system, there could be significant clinical benefit from creating personalized treatment regimens. Ultimately, if this approach is effective it may encourage higher adoption of generic statins when appropriate, promote adherence, lower rates of myopathy, and overall achieve higher value cardiovascular care. This paper will review the evidence for personalized prescribing of statins via KIF6 and SLCO1B1 and consider some of the implications for testing these markers as part of routine clinical care.
Keywords: statins; adherence; myopathy; KIF6; SLCO1B1 statins; adherence; myopathy; KIF6; SLCO1B1
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Canestaro, W.J.; Brooks, D.G.; Chaplin, D.; Choudhry, N.K.; Lawler, E.; Martell, L.; Brennan, T.; Wassman, E.R. Statin Pharmacogenomics: Opportunities to Improve Patient Outcomes and Healthcare Costs with Genetic Testing. J. Pers. Med. 2012, 2, 158-174.

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