N.V. Sklifosovsky Institute of Clinical Medicine, Department of Clinical Pharmacology and Propaedeutics of Internal Diseases, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
N.V. Sklifosovsky Institute of Clinical Medicine, Department of Polyclinical Therapy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.
Lipids Health Dis. 2021 Nov 8;20(1):157. doi: 10.1186/s12944-021-01586-7.
To determine the effect of genetic polymorphism of drug transporters on the efficacy of treatment with Rosuvastatin, Atorvastatin and Simvastatin in patients with hyperlipidemia.
The study consists of 180 patients, aged 40-75 years, with hyperlipidemia. All patients were divided into two equal groups: patients with different SLCO1B1 (521CC, 521CT and 521TT) and MDR1 (3435CC, 3435TC and 3435TT) genotypes. Each group was divided into rosuvastatin-treated, atorvastatin-treated and simvastatin-treated subgroups. The lipid-lowering effect of statins was assessed by tracing changes in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels.
The use of statins over a 4-month period led to substantial reductions in TC and LDL-C levels. The hypolipidemic effect of studied agents was seen in both groups. However, it was less pronounced in patients with 521CC genotype. No statistically significantly differences were found between carriers of 3435TT, 3435CT and 3435CC genotypes.
The lipid-lowering efficacy of rosuvastatin was higher compared to other two statins. Patients with SLCO1B1 521CC genotype are more likely to encounter a decrease in the hypolipidemic effect of statins. Such a risk should be considered when treating this category of patients. MDR1 polymorphism had no significant effect on statin efficacy.
为了确定药物转运体的遗传多态性对高脂血症患者使用瑞舒伐他汀、阿托伐他汀和辛伐他汀治疗效果的影响。
本研究纳入了 180 名年龄在 40-75 岁的高脂血症患者。所有患者均分为两组:具有不同 SLCO1B1(521CC、521CT 和 521TT)和 MDR1(3435CC、3435TC 和 3435TT)基因型的患者。每组再分为瑞舒伐他汀组、阿托伐他汀组和辛伐他汀组。通过追踪总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平的变化来评估他汀类药物的降脂效果。
使用他汀类药物 4 个月后,TC 和 LDL-C 水平显著降低。研究药物在两组患者中均具有降脂作用。然而,在具有 521CC 基因型的患者中,这种作用不太明显。3435TT、3435CT 和 3435CC 基因型携带者之间未发现统计学上显著差异。
与其他两种他汀类药物相比,瑞舒伐他汀的降脂效果更高。具有 SLCO1B1 521CC 基因型的患者更有可能遇到他汀类药物降脂作用降低的情况。在治疗此类患者时,应考虑到这种风险。MDR1 多态性对他汀类药物的疗效没有显著影响。