从药物基因组学角度探讨他汀类药物引起的肌病的治疗和管理。
Pharmacogenomic insights into treatment and management of statin-induced myopathy.
机构信息
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), University of Utrecht, 3508 TB Utrecht, The Netherlands.
出版信息
Genome Med. 2009 Dec 29;1(12):120. doi: 10.1186/gm120.
Although statins are generally well tolerated, the most common adverse drug reaction from statin therapy is myopathy. This article reviews the current pharmacogenomic knowledge of statin-induced myopathy. Furthermore, we will discuss the importance of recent pharmacogenetic advances for the treatment and management of statin-induced myopathy. Variation in the SLCO1B1 gene is associated with increased incidence of statin-induced myopathy, particularly with simvastatin and less so with other statins. If different pharmacokinetic enzymes and transporters are responsible for susceptibility to myopathy, this may explain differences in the occurrence of statin-induced myopathy in individual patients. Genotyping in patients suffering from statin-induced myopathy may help to personalize the choice of statin for the lowest chance of developing myopathy.
尽管他汀类药物通常耐受性良好，但他汀类药物治疗最常见的不良反应是肌病。本文综述了他汀类药物诱导肌病的当前药物基因组学知识。此外，我们还将讨论最近药物基因组学进展对他汀类药物诱导肌病的治疗和管理的重要性。SLCO1B1 基因的变异与他汀类药物诱导的肌病发生率增加有关，特别是与辛伐他汀相关，而与其他他汀类药物的相关性较小。如果不同的药代动力学酶和转运体与肌病易感性有关，这可能解释了个体患者中他汀类药物诱导的肌病发生的差异。对他汀类药物诱导肌病患者进行基因分型可能有助于根据发生肌病的最低风险来个体化选择他汀类药物。
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