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The Clinical Pharmacogenetics Implementation Consortium Guideline for SLCO1B1 , ABCG2 , and CYP2C9 genotypes and Statin‐Associated Musculoskeletal Symptoms

Cooper‐DeHoff, Rhonda M., Niemi, Mikko, Ramsey, Laura B., Luzum, Jasmine A., Tarkiainen, E. Katriina, Straka, Robert J., Gong, Li, Tuteja, Sony, Wilke, Russell A., Wadelius, Mia, Larson, Eric A., Roden, Dan M., Klein, Teri E., Yee, Sook Wah, Krauss, Ronald M., Turner, Richard M., Palaniappan, Latha, Gaedigk, Andrea, Giacomini, Kathleen M., Caudle, Kelly E., Voora, Deepak·2022·Clinical Pharmacology & Therapeutics

Abstract

Statins reduce cholesterol, prevent cardiovascular disease, and are among the most commonly prescribed medications in the world. Statin‐associated musculoskeletal symptoms (SAMS) impact statin adherence and ultimately can impede the long‐term effectiveness of statin therapy. There are several identified pharmacogenetic variants that impact statin disposition and adverse events during statin therapy. SLCO1B1 encodes a transporter (SLCO1B1; alternative names include OATP1B1 or OATP‐C) that facilitates the hepatic uptake of all statins. ABCG2 encodes an efflux transporter (BCRP) that modulates the absorption and disposition of rosuvastatin. CYP2C9 encodes a phase I drug metabolizing enzyme responsible for the oxidation of some statins. Genetic variation in each of these genes alters systemic exposure to statins (i.e., simvastatin, rosuvastatin, pravastatin, pitavastatin, atorvastatin, fluvastatin, lovastatin), which can increase the risk for SAMS. We summarize the literature supporting these associations and provide therapeutic recommendations for statins based on SLCO1B1 , ABCG2 , and CYP2C9 genotype with the goal of improving the overall safety, adherence, and effectiveness of statin therapy. This document replaces the 2012 and 2014 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for SLCO1B1 and simvastatin‐induced myopathy.

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Metadata

Authors
Cooper‐DeHoff, R. M., Niemi, M., Ramsey, L. B., Luzum, J. A., Tarkiainen, E. K., Straka, R. J., Gong, L., Tuteja, S., Wilke, R. A., Wadelius, M., Larson, E. A., Roden, D. M., Klein, T. E., Yee, S. W., Krauss, R. M., Turner, R. M., Palaniappan, L., Gaedigk, A., Giacomini, K. M., Caudle, K. E., & Voora, D.
Affiliations
  • Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine College of Pharmacy University of Florida Gainesville Florida USA
  • Department of Clinical Pharmacology Individualized Drug Therapy Research Program University of Helsinki Helsinki Finland
  • Divisions of Clinical Pharmacology & Research in Patient Services Cincinnati Children’s Hospital Medical Center Cincinnati Ohio USA
  • Department of Clinical Pharmacy University of Michigan College of Pharmacy Ann Arbor Michigan USA
  • Department of Experimental and Clinical Pharmacology University of Minnesota College of Pharmacy Minneapolis Minnesota USA
  • Department of Biomedical Data Science School of Medicine Stanford University Stanford California USA
  • Department of Medicine University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA
  • Department of Internal Medicine University of South Dakota Sanford School of Medicine Sioux Falls South Dakota USA
  • Department of Medical Sciences Clinical Pharmacogenomics & Science for Life Laboratory Uppsala University Uppsala Sweden
  • Division of Cardiovascular Medicine and Division of Clinical Pharmacology Department of Medicine Vanderbilt University Medical Center Nashville Tennessee USA
  • Department of Bioengineering and Therapeutic Sciences University of California San Francisco San Francisco California USA
  • Departments of Pediatrics and Medicine University of California San Francisco California USA
  • The Wolfson Centre for Personalised Medicine University of Liverpool Liverpool UK
  • Division of Primary Care and Population Health Stanford University School of Medicine Stanford California USA
  • Division of Clinical Pharmacology, Toxicology, and Therapeutic Innovation Children's Mercy Kansas City and School of Medicine University of Missouri‐Kansas City Kansas City Missouri USA
  • Division of Pharmaceutical Sciences Department of Pharmacy and Pharmaceutical Sciences St. Jude Children’s Research Hospital Memphis Tennessee USA
  • Department of Medicine Duke Center for Applied Genomics & Precision Medicine Duke University School of Medicine Durham North Carolina USA
Venue
Clinical Pharmacology & Therapeutics
Publisher
Wiley
Published
2022-03-11
Volume
111
Issue
5
Pages
1007-1021
ISSN
  • 0009-9236
  • 1532-6535
Cited by
380
References
8
Language
en
Funders
  • National Institutes of Health (R24GM115264, U24HG010135)
  • H2020 European Research Council (725249)

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CoChat. (2026). Citation check: The Clinical Pharmacogenetics Implementation Consortium Guideline for SLCO1B1 , ABCG2 , and CYP2C9 genotypes and Statin‐Associated Musculoskeletal Symptoms. https://app.cochat.ai/papers/10.1002/cpt.2557
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Cooper‐DeHoff, R. M., Niemi, M., Ramsey, L. B., Luzum, J. A., Tarkiainen, E. K., Straka, R. J., Gong, L., Tuteja, S., Wilke, R. A., Wadelius, M., Larson, E. A., Roden, D. M., Klein, T. E., Yee, S. W., Krauss, R. M., Turner, R. M., Palaniappan, L., Gaedigk, A., Giacomini, K. M., . . . Voora, D. (2022). The Clinical Pharmacogenetics Implementation Consortium Guideline for SLCO1B1 , ABCG2 , and CYP2C9 genotypes and Statin‐Associated Musculoskeletal Symptoms. Clinical Pharmacology & Therapeutics. https://doi.org/10.1002/cpt.2557

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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.