Progression of Precision Statin Prescribing for Reduction of Statin-Associated Muscle Symptoms

Abstract

Background: Statins are among the most commonly prescribed medications, and improve patient outcomes by lowering cholesterol levels, but also have side effects. Variations in statin response can be attributed to a handful of factors that include pharmacogenetics. Methods: While not a true review article, this work was written using various search engines and terms and previous and newly published Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for statins to provide a historical perspective in addition to the current status of statin-related pharmacogenetics and future perspectives. Results: This article provides historical background on statins and associated adverse effects, reviews pharmacogenetic implications, applies clinical decision support, incorporates the latest CPIC guidelines and addresses future implications. Conclusion: Statins are a beneficial medication, but not without risk. Pharmacogenomics can help mitigate some risk factors. Clinical decision support, implementation, research and guidelines will continue to influence statin prescribing.

Keywords::

• ABCG2
• clinical decision support
• CYP2C9
• myalgia
• myopathy
• pharmacogenomics
• SLCO1B1
• statins

Author contributions

All authors participated in the design of the study and the writing, editing and final approval of the manuscript. All authors agree to be accountable for all aspects of the work.

Acknowledgments

The authors thank MStensgaard for her helpful assistance with formatting references and C Larson for his work on statin alerts.

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.