Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between SLCO1B1 and statins and CYP2C9 and sulfonylureas.

Autor: Wolthuis DFGJ; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands., Nijenhuis M; Royal Dutch Pharmacists Association (KNMP), The Hague, The Netherlands. M.Nijenhuis@knmp.nl., Soree B; Royal Dutch Pharmacists Association (KNMP), The Hague, The Netherlands., de Boer-Veger NJ; Department of Clinical Pharmacy, Martini Hospital, Groningen, The Netherlands., Buunk AM; Pharmacy De Katwijkse Apotheek, Katwijk, The Netherlands., Guchelaar HJ; Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands., Risselada A; Department of Clinical Pharmacy, Wilhelmina Hospital, Assen, The Netherlands., Rongen GAPJM; Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.; Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands., van Schaik RHN; Department of Clinical Chemistry, Erasmus University Medical Center, Rotterdam, The Netherlands., Swen JJ; Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands., Touw DJ; Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Department of Pharmaceutical Analysis, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands., van Westrhenen R; Department of Psychiatry, Parnassia Group, Amsterdam, The Netherlands.; St. John's National Academy of Health Sciences, Banglore, India.; Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK., Deneer VHM; Department of Clinical Pharmacy, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands.; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands., Houwink EJF; Department of Family Medicine, Public Health and Primary Care (PHEG), Mayo Clinic, Rochester, MN, USA.; Department of Public Health and Primary Care (PHEG), Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: European journal of human genetics : EJHG [Eur J Hum Genet] 2024 Dec 15. Date of Electronic Publication: 2024 Dec 15.
DOI: 10.1038/s41431-024-01769-7
Abstrakt: Aligned with the mission of the Dutch Pharmacogenetics Working Group (DPWG) to promote the implementation of pharmacogenetics (PGx), this guideline is specifically designed to optimize pharmacotherapy of cholesterol lowering medication (statins) and glucose lowering medication (sulfonylureas). The SLCO1B1 c.521 T > C variant reduces the activity of the SLCO1B1 transporter involved in statin transport out of the blood into the liver. High blood concentrations of statins increase the risk of serious myopathy. For simvastatin, the DPWG recommends choosing an alternative in homozygotes for these gene variant and to preferably choose an alternative in heterozygotes. For atorvastatin, the DPWG recommends to preferably choose an alternative in carriers of this gene variant having additional risk factors for myopathy. For rosuvastatin, the DPWG recommends keeping the dose as low as possible in carriers of this gene variant with additional risk factors. No therapy adjustment is required for fluvastatin and pravastatin in carriers of this gene variant. Gene variants can diminish the activity of the enzyme CYP2C9, that converts sulfonylurea to less effective metabolites. Although CYP2C9 gene variants may lead to increased levels of glibenclamide, gliclazide, glimepiride, and tolbutamide, no therapy adjustments are required in patients with these variants. The main reason is that there was either no negative clinical effect or an increase in hypoglycemic, which is of less importance than the increase in effectiveness it signals. The DPWG classifies pre-emptive SLCO1B1 testing as 'essential' for simvastatin 80 mg/day, 'beneficial' for simvastatin up to 40 mg/day, and 'potentially beneficial' for atorvastatin and rosuvastatin.
Competing Interests: Competing interests: The Pharmacogenetics Working Group of the KNMP (DPWG) formulates the optimal recommendations for each phenotype group based on the available evidence. If this optimal recommendation cannot be followed due to practical restrictions, e.g. therapeutic drug monitoring or a lower dose is not available, then the health care professional should consider the next best option.
(© 2024. The Author(s), under exclusive licence to European Society of Human Genetics.)
Databáze: MEDLINE
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