Ward Family Heart Center, Children's Mercy, Kansas City, Missouri, USA.
Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation, Children's Mercy, Kansas City, Missouri, USA.
Clin Transl Sci. 2020 May;13(3):628-637. doi: 10.1111/cts.12749. Epub 2020 Mar 9.
This study investigated the impact of SLCO1B1 genotype on rosuvastatin systemic exposure in hypercholesterolemic children and adolescents. Participants (8-21 years) with at least one allelic variant of SLCO1B1 c.521T>C (521TC, n = 13; 521CC, n = 2) and wild type controls (521TT, n = 13) completed a single oral dose pharmacokinetic study. The variability contributed by SLCO1B1 c.521 sequence variation to rosuvastatin (RVA) systemic exposure among our pediatric cohort was comparable to previous studies in adults. RVA concentration-time curve from 0-24 hours (AUC ) was 1.4-fold and 2.2-fold higher in participants with c.521TC and c.521CC genotype compared 521TT participants, respectively. Interindividual variability of RVA exposure within SLCO1B1 genotype groups exceeded the ~ 1.5-fold to 2-fold difference in mean RVA exposure observed among SLCO1B1 genotype groups, suggesting that other factors also contribute to interindividual variability in the rosuvastatin dose-exposure relationship. A multivariate model performed confirmed SLCO1B1 c.521T>C genotype as the primary factor contributing to RVA systemic exposure in this pediatric cohort, accounting for ~ 30% of the variability RVA AUC . However, of the statins investigated to date in the pediatric population, RVA has the lowest magnitude of variability in systemic exposure.
本研究调查了 SLCO1B1 基因型对高胆固醇血症儿童和青少年瑞舒伐他汀系统暴露的影响。至少有一种 SLCO1B1 c.521T>C(521TC,n=13;521CC,n=2)等位基因变异和野生型对照(521TT,n=13)的参与者完成了单次口服药代动力学研究。SLCO1B1 c.521 序列变异对我们儿科队列中瑞舒伐他汀(RVA)系统暴露的变异性与先前在成人中的研究相当。与 521TT 参与者相比,c.521TC 和 c.521CC 基因型参与者的 0-24 小时 RVA 浓度-时间曲线(AUC)分别高出 1.4 倍和 2.2 倍。在 SLCO1B1 基因型组内,RVA 暴露的个体间变异性超过了 SLCO1B1 基因型组之间观察到的平均 RVA 暴露的 1.5 倍至 2 倍差异,表明其他因素也导致了瑞舒伐他汀剂量-暴露关系的个体间变异性。进行的多变量模型证实,SLCO1B1 c.521T>C 基因型是导致该儿科队列中 RVA 系统暴露的主要因素,占 RVA AUC 变异性的~30%。然而,迄今为止在儿科人群中研究的他汀类药物中,RVA 对系统暴露的变异性最小。