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Int. J. Mol. Sci. 2017, 18(1), 104;

Pharmacogenetic Foundations of Therapeutic Efficacy and Adverse Events of Statins

Clinical Pharmacology and Pharmacogenetic Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 55, 56126 Pisa, Italy
Department of Pharmacy, University of Pisa, Via Bonanno Pisano 6, 56126 Pisa, Italy
Author to whom correspondence should be addressed.
Academic Editors: Sabrina Angelini and Gloria Ravegnini
Received: 30 November 2016 / Revised: 29 December 2016 / Accepted: 30 December 2016 / Published: 6 January 2017
(This article belongs to the Special Issue Pharmacogenetics and Personalized Medicine 2016)
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Background: In the era of precision medicine, more attention is paid to the search for predictive markers of treatment efficacy and tolerability. Statins are one of the classes of drugs that could benefit from this approach because of their wide use and their incidence of adverse events. Methods: Literature from PubMed databases and bibliography from retrieved publications have been analyzed according to terms such as statins, pharmacogenetics, epigenetics, toxicity and drug–drug interaction, among others. The search was performed until 1 October 2016 for articles published in English language. Results: Several technical and methodological approaches have been adopted, including candidate gene and next generation sequencing (NGS) analyses, the latter being more robust and reliable. Among genes identified as possible predictive factors associated with statins toxicity, cytochrome P450 isoforms, transmembrane transporters and mitochondrial enzymes are the best characterized. Finally, the solute carrier organic anion transporter family member 1B1 (SLCO1B1) transporter seems to be the best target for future studies. Moreover, drug–drug interactions need to be considered for the best approach to personalized treatment. Conclusions: Pharmacogenetics of statins includes several possible genes and their polymorphisms, but muscular toxicities seem better related to SLCO1B1 variant alleles. Their analysis in the general population of patients taking statins could improve treatment adherence and efficacy; however, the cost–efficacy ratio should be carefully evaluated. View Full-Text
Keywords: statins; pharmacogenetics; epigenetics; drug transporters; toxicity statins; pharmacogenetics; epigenetics; drug transporters; toxicity

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Arrigoni, E.; Del Re, M.; Fidilio, L.; Fogli, S.; Danesi, R.; Di Paolo, A. Pharmacogenetic Foundations of Therapeutic Efficacy and Adverse Events of Statins. Int. J. Mol. Sci. 2017, 18, 104.

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