06:37pm Thursday 14 November 2019

Vanderbilt doctors to screen patients taking cholesterol-lowering drugs for harmful genetic variation

Statin drugs are among the world’s most commonly prescribed medications and are used to lower cholesterol levels in the blood.

Simvastatin, the generic form of the statin Zocor, is one of the most widely prescribed drugs in the United States and is effective in reducing LDL-cholesterol levels and lowering the risk for heart attacks and strokes.

But growing evidence indicates that about 2 percent of patients taking 80 milligrams of simvastatin per day will experience muscle aches that could lead to muscle damage. In extreme cases complications can be more severe, such as kidney damage and even death.

The risk for developing complications is increased when a patient carries even a single genetic variation, according to Vanderbilt’s Dan Roden, M.D., assistant vice chancellor for Personalized Medicine.

“If you have two copies of the SLC01B1 gene, you’re at an almost 20-fold increased risk of muscle toxicity,” he said.

“We’re just reducing the odds. That’s what applying genetics at the bedside is all about. It expands what you know about the individual patient.”

Vanderbilt, as part of its personalized medicine initiative, PREDICT, is the first academic medical center to offer patients screening for this genetic variant. The program’s roll out will begin in VUMC’s adult Primary Care and Cardiology clinics.

After genetic testing, the patient’s genetic information is entered into their electronic medical record, and health care providers will receive an alert before being able to prescribe simvastatin if a patient is at increased risk for developing clinically meaningful side effects.

“PREDICT allows providers to tailor drug therapy based on an individual’s unique genetic makeup so patients will be more likely to receive the right drug, at the right dose, the first time,” said Russell Wilke, M.D., associate professor of Medicine in Clinical Pharmacology.

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