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Cerivastatin, genetic variants, and the risk of rhabdomyolysis.

TitleCerivastatin, genetic variants, and the risk of rhabdomyolysis.
Publication TypeJournal Article
Year of Publication2011
AuthorsMarciante, KD, Durda, JP, Heckbert, SR, Lumley, T, Rice, K, McKnight, B, Totah, RA, Tamraz, B, Kroetz, DL, Fukushima, H, Kaspera, R, Bis, JC, Glazer, NL, Li, G, Austin, TR, Taylor, KD, Rotter, JI, Jaquish, CE, Kwok, P-Y, Tracy, RP, Psaty, BM
JournalPharmacogenet Genomics
Volume21
Issue5
Pagination280-8
Date Published2011 May
ISSN1744-6880
KeywordsAdult, Aged, Aged, 80 and over, Aryl Hydrocarbon Hydroxylases, Case-Control Studies, Cytochrome P-450 CYP2C8, Female, Genetic Variation, Genome-Wide Association Study, Glucuronosyltransferase, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Middle Aged, Organic Anion Transporters, Polymorphism, Single Nucleotide, Pyridines, Rhabdomyolysis, Risk, Ryanodine Receptor Calcium Release Channel, Solute Carrier Organic Anion Transporter Family Member 1b1
Abstract<p><b>OBJECTIVE: </b>The withdrawal of cerivastatin involved an uncommon but serious adverse reaction, rhabdomyolysis. The bimodal response, rhabdomyolysis in a small proportion of users, points to genetic factors as a potential cause. We conducted a case-control study to evaluate genetic markers for cerivastatin-associated rhabdomyolysis.</p><p><b>METHODS: </b>This study had two components: a candidate gene study to evaluate variants in CYP2C8, UGT1A1, UGT1A3, and SLCO1B1; and a genome-wide association study to identify risk factors in other regions of the genome. A total of 185 rhabdomyolysis cases were frequency matched to statin-using controls from the Cardiovascular Health Study (n=374) and the Heart and Vascular Health Study (n=358). Validation relied on functional studies.</p><p><b>RESULTS: </b>Permutation test results suggested an association between cerivastatin-associated rhabdomyolysis and variants in SLCO1B1 (P=0.002), but not variants in CYP2C8 (P=0.073) or UGTs (P=0.523). An additional copy of the minor allele of SLCO1B1 rs4149056 (p.Val174Ala) was associated with the risk of rhabdomyolysis (odds ratio: 1.89; 95% confidence interval: 1.40-2.56). In transfected cells, this variant reduced cerivastatin transport by 40% compared with the reference transporter (P<0.001). The genome-wide association study identified an intronic variant (rs2819742) in the ryanodine receptor 2 gene (RYR2) as significant (P=1.74E-07). An additional copy of the minor allele of the RYR2 variant was associated with a reduced risk of rhabdomyolysis (odds ratio: 0.48; 95% confidence interval: 0.36-0.63).</p><p><b>CONCLUSION: </b>We identified modest genetic risk factors for an extreme response to cerivastatin. Disabling genetic variants in the candidate genes were not responsible for the bimodal response to cerivastatin.</p>
DOI10.1097/FPC.0b013e328343dd7d
Alternate JournalPharmacogenet. Genomics
PubMed ID21386754
PubMed Central IDPMC3076530
Grant ListM01-RR00425 / RR / NCRR NIH HHS / United States
N01 HC085086 / HC / NHLBI NIH HHS / United States
HL068639 / HL / NHLBI NIH HHS / United States
N01-HC-85085 / HC / NHLBI NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
N01 HC075150 / HC / NHLBI NIH HHS / United States
HL085251 / HL / NHLBI NIH HHS / United States
N01-HC-85081 / HC / NHLBI NIH HHS / United States
R01 HL068986 / HL / NHLBI NIH HHS / United States
HL73410 / HL / NHLBI NIH HHS / United States
N01 HC015103 / HC / NHLBI NIH HHS / United States
R01 HL085251 / HL / NHLBI NIH HHS / United States
P30 DK063491-06 / DK / NIDDK NIH HHS / United States
R01 HL068639 / HL / NHLBI NIH HHS / United States
R01 HL078888 / HL / NHLBI NIH HHS / United States
R01 HL087652-01 / HL / NHLBI NIH HHS / United States
R01 HL087652 / HL / NHLBI NIH HHS / United States
R01 HL078888-01A1 / HL / NHLBI NIH HHS / United States
N01HC55222 / HL / NHLBI NIH HHS / United States
R01 HL074745 / HL / NHLBI NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
HL068986 / HL / NHLBI NIH HHS / United States
R01 HL085251-01A1 / HL / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
HL074745 / HL / NHLBI NIH HHS / United States
N01-HC-85082 / HC / NHLBI NIH HHS / United States
P30 DK063491 / DK / NIDDK NIH HHS / United States
GM61390 / GM / NIGMS NIH HHS / United States
N01 HC055222 / HC / NHLBI NIH HHS / United States
N01-HC45133 / HC / NHLBI NIH HHS / United States
N01-HC-55222 / HC / NHLBI NIH HHS / United States
U01 GM061390 / GM / NIGMS NIH HHS / United States
N01-HC-85083 / HC / NHLBI NIH HHS / United States
N01-HC-75150 / HC / NHLBI NIH HHS / United States
N01-HC-85080 / HC / NHLBI NIH HHS / United States
R01 HL080295 / HL / NHLBI NIH HHS / United States
U19 GM061390 / GM / NIGMS NIH HHS / United States
HL078888 / HL / NHLBI NIH HHS / United States
R01 HL074745-01 / HL / NHLBI NIH HHS / United States
M01 RR000425 / RR / NCRR NIH HHS / United States
R01 HL043201-09A1 / HL / NHLBI NIH HHS / United States
U01 GM061390-01 / GM / NIGMS NIH HHS / United States
R01 HL068986-01A1 / HL / NHLBI NIH HHS / United States
R01HL087652 / HL / NHLBI NIH HHS / United States
N01HC75150 / HL / NHLBI NIH HHS / United States
R01 HL043201 / HL / NHLBI NIH HHS / United States
HL43201 / HL / NHLBI NIH HHS / United States
DK063491 / DK / NIDDK NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
R01 HL080295-05 / HL / NHLBI NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States
N01 HC085079 / HC / NHLBI NIH HHS / United States
R01 HL073410-01A1 / HL / NHLBI NIH HHS / United States
R01 HL073410 / HL / NHLBI NIH HHS / United States
N01 HC045133 / HC / NHLBI NIH HHS / United States
N01 HC035129 / HC / NHLBI NIH HHS / United States
N01-HC-85084 / HC / NHLBI NIH HHS / United States
R01 HL068639-01 / HL / NHLBI NIH HHS / United States
M01 RR000425-30S1 / RR / NCRR NIH HHS / United States