Department of Pharmacotherapy & Outcome Science, Virginia Commonwealth University School of Pharmacy, 410 N 12th Street, Richmond, VA 23298, USA.
Department of Pharmacy Practice, King Faisal University College of Clinical Pharmacy, P.O. Box 400, Hofuf, Eastern Province, 31982, Saudi Arabia.
Pharmacogenomics. 2023 Jan;24(1):15-26. doi: 10.2217/pgs-2022-0155. Epub 2023 Jan 18.
Statins are widely used medications for the primary and secondary prevention of cardiovascular diseases. Statin-induced musculoskeletal symptoms are the primary adverse drug events contributing to poor adherence to lipid-lowering therapy. Rosuvastatin is characterized by interindividual differences in systemic exposure among different patient population subgroups. The missense variant within , highly prevalent in some Asian subgroups, results in decreased transporter efflux function and increased exposure to rosuvastatin. We aim to highlight the implications of genotype in prescribing rosuvastatin and the ramifications of interpopulation differences in frequencies in the starting dose of rosuvastatin in major Asian subgroups, using the most recent genetic-based guidelines. The high frequency of in Filipinos could warrant a lower starting rosuvastatin dose versus non-Filipinos. The genotype frequencies in Asian subgroups suggest significant interpopulation differences, reinforcing the need to move beyond race-based to genotype-based rosuvastatin dosing.
他汀类药物被广泛用于心血管疾病的一级和二级预防。他汀类药物引起的肌肉骨骼症状是导致降脂治疗依从性差的主要药物不良事件。在不同的患者亚组中,瑞舒伐他汀的全身暴露存在个体间差异。在一些亚洲亚组中高度流行的错义变体 ,导致转运体外排功能降低和瑞舒伐他汀暴露增加。我们旨在使用最新的基于遗传的指南,强调 基因型在开具瑞舒伐他汀处方中的意义,以及 等位基因频率在亚洲主要亚组中瑞舒伐他汀起始剂量中的差异的影响。在菲律宾人中 等位基因的高频率可能需要比非菲律宾人更低的起始瑞舒伐他汀剂量。亚洲亚组中的 基因型频率表明存在显著的人群差异,这进一步强调需要从基于种族的瑞舒伐他汀剂量调整转向基于基因型的瑞舒伐他汀剂量调整。