Genetic contribution to lipid target achievement with statin therapy: a prospective study

Pharmacogenomics J. 2020 Jun;20(3):494-504. doi: 10.1038/s41397-019-0136-7. Epub 2019 Dec 6.

Abstract

Statin therapy response is highly variable. Variants of lipid metabolism genes and statin pharmacokinetic modulators could play a role, however, the impact of most of these variants remains unconfirmed. A prospective and multicenter study included 252 patients was carried out in order to assess, according to achievement of LDL-C or non-HDL-C therapeutic targets and quantitative changes in lipid profiles, the impact of CETP, ABCA1, CYP2D6, and CYP2C9 gene candidate variants on the simvastatin, atorvastatin, and rosuvastatin response. Patients carrier ABCA1 rs2230806 and CYP2D6*3 variants are less likely to achieve therapeutic lipid targets (p = 0.020, OR = 0.59 [0.37, 0.93]; p = 0.040, OR = 0.23 [0.05, 0.93], respectively). Among CETP variants, rs708272 was linked to a 10.56% smaller reduction in LDL-C with rosuvastatin (95% CI = [1.27, 19.86] %; p = 0.028). In contrast, carriers of rs5882 had a 13.33% greater reduction in LDL-C (95% CI = [25.38, 1.28]; p = 0.032). If these findings are confirmed, ABCA1, CYP2D6, and CETP genotyping could be used to help predict which statin and dosage is appropriate in order to improve personalized medicine.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • ATP Binding Cassette Transporter 1 / genetics*
  • Cholesterol Ester Transfer Proteins / genetics*
  • Cholesterol, HDL / antagonists & inhibitors
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / antagonists & inhibitors
  • Cholesterol, LDL / blood*
  • Cytochrome P-450 CYP2D6 / genetics*
  • Female
  • Follow-Up Studies
  • Genetic Variation / genetics
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Hyperlipidemias / blood
  • Hyperlipidemias / drug therapy
  • Hyperlipidemias / genetics
  • Lipids / antagonists & inhibitors
  • Lipids / blood
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • ABCA1 protein, human
  • ATP Binding Cassette Transporter 1
  • CETP protein, human
  • Cholesterol Ester Transfer Proteins
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids
  • Cytochrome P-450 CYP2D6