A pilot study on the association between SLCO1B1 RS4363657 polymorphism and muscle adverse events in adults with newly diagnosed dyslipidaemia who were prescribed a statin: the Malaysian primary health care cohort

Abstract

Introduction: Statin, the first-line treatment for dyslipidaemia, may have suboptimal adherence due to its associated muscle adverse events. These data, however, remain limited.

Aim: To determine the association of serum creatine kinase (CK) and SLCO1B1 rs4363657 polymorphism with statin-associated muscle adverse events (SAMAE) among dyslipidaemia participants.

Methods: This was a prospective cohort study at government health clinics involving newly diagnosed adults with dyslipidaemia. SAMAE were recorded based on the patient’s complaint after a month on statin. CK was taken at baseline and follow-up. Genetic profiling was performed for SLCO1B1 rs4363657 polymorphism.

Results: Among 118 participants, majority were Malay (72%) males (61%) with a mean age of 49 ± 12.2 years old and prescribed lovastatin (61.9). There was a significant association between statin types (lovastatin and simvastatin) and SAMAE (p = 0.0327); no significant association noted between CK and SAMAE (p = 0.5637). The SLCO1B1 rs4363657 polymorphism was significantly associated SAMAE (p < 0.0001).

Conclusions: In this first pilot study of a multiethnic Malaysian population, the incidence of SAMAE was 18.6%. SAMAE were significantly higher in subjects on lovastatin compared to simvastatin. SLCO1B1 rs4363657 polymorphism was a significant risk factor for SAMAE.

Keywords:

• Dyslipidaemia
• statin-associated muscle adverse events
• SLCO1B1
• rs4363657
• creatine kinase
• simvastatin
• lovastatin

Acknowledgements

The authors would like to thank the Director-General of Health Malaysia for approving publication of this paper. A special appreciation to the Director of Selangor State Health Department (JKNS) for permitting this study. The authors would like to extend their gratitude to the clinicians of the government health clinics (Kajang, Bandar Baru Bangi and Dengkil) and staff of Chemical Pathology and Pharmacotherapeutic Laboratories, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia for their contribution in this study.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This study was funded by both the Universiti Putra Malaysia Research University Grant Scheme (RUGS Project No: 9338400) and UPM Graduate Supervision Grant.