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SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care.

Publication ,  Journal Article
Voora, D; Baye, J; McDermaid, A; Narayana Gowda, S; Wilke, RA; Nicole Myrmoe, A; Hajek, C; Larson, EA
Published in: Clin Pharmacol Ther
May 2022

The SLCO1B1 genotype is known to influence patient adherence to statin therapy, in part by increasing the risk for statin-associated musculoskeletal symptoms (SAMSs). The SLCO1B1*5 allele has previously been associated with simvastatin discontinuation and SAMSs. Prior analyses of the relationship between SLCO1B1*5 and atorvastatin muscle side effects have been inconclusive due to insufficient power. We now quantify the impact of SLCO1B1*5 on atorvastatin discontinuation and SAMSs in a large observational cohort using electronic medical record data from a single health care system. In our study cohort (n = 1,627 patients exposed to atorvastatin during the course of routine clinical care), 56% (n = 912 of 1,627 patients) discontinued atorvastatin and 18% (n = 303 of 1,627 patients) developed SAMSs. A univariate model revealed that SLCO1B1*5 increased the likelihood that patients would stop atorvastatin during routine care (odds ratio 1.2; 95% confidence interval (CI), 1.1-1.5; P = 0.04). A multivariate Cox proportional hazards model further demonstrated that this same variant was associated with time to atorvastatin discontinuation (hazard ratio 1.2; 95% CI, 1.1-1.4; P = 0.004). Additional time-to-event analyses also revealed that SCLO1B1*5 was associated with SAMSs (hazard ratio 1.4; 95% CI, 1.1-1.7; P = 0.02). Atorvastatin discontinuation was associated with SAMSs (odds ratio 1.67; P = 0.0001) in our cohort.

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Published In

Clin Pharmacol Ther

DOI

EISSN

1532-6535

Publication Date

May 2022

Volume

111

Issue

5

Start / End Page

1075 / 1083

Location

United States

Related Subject Headings

  • Simvastatin
  • Pyrroles
  • Polymorphism, Single Nucleotide
  • Pharmacology & Pharmacy
  • Muscles
  • Liver-Specific Organic Anion Transporter 1
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Atorvastatin
  • Alleles
 

Citation

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Voora, D., Baye, J., McDermaid, A., Narayana Gowda, S., Wilke, R. A., Nicole Myrmoe, A., … Larson, E. A. (2022). SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care. Clin Pharmacol Ther, 111(5), 1075–1083. https://doi.org/10.1002/cpt.2527
Voora, Deepak, Jordan Baye, Adam McDermaid, Smitha Narayana Gowda, Russell A. Wilke, Anna Nicole Myrmoe, Catherine Hajek, and Eric A. Larson. “SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care.Clin Pharmacol Ther 111, no. 5 (May 2022): 1075–83. https://doi.org/10.1002/cpt.2527.
Voora D, Baye J, McDermaid A, Narayana Gowda S, Wilke RA, Nicole Myrmoe A, et al. SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care. Clin Pharmacol Ther. 2022 May;111(5):1075–83.
Voora, Deepak, et al. “SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care.Clin Pharmacol Ther, vol. 111, no. 5, May 2022, pp. 1075–83. Pubmed, doi:10.1002/cpt.2527.
Voora D, Baye J, McDermaid A, Narayana Gowda S, Wilke RA, Nicole Myrmoe A, Hajek C, Larson EA. SLCO1B1*5 Allele Is Associated With Atorvastatin Discontinuation and Adverse Muscle Symptoms in the Context of Routine Care. Clin Pharmacol Ther. 2022 May;111(5):1075–1083.
Journal cover image

Published In

Clin Pharmacol Ther

DOI

EISSN

1532-6535

Publication Date

May 2022

Volume

111

Issue

5

Start / End Page

1075 / 1083

Location

United States

Related Subject Headings

  • Simvastatin
  • Pyrroles
  • Polymorphism, Single Nucleotide
  • Pharmacology & Pharmacy
  • Muscles
  • Liver-Specific Organic Anion Transporter 1
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Atorvastatin
  • Alleles