title: Pharmacogenetics of Lipid-Lowering Agents: Precision or Indecision Medicine?
abstract: Lipid-lowering medications, particularly statins, have been a popular target for pharmacogenetic studies. A handful of genes have shown promise for predicting response to therapy from the perspective of lipid lowering, as well as myopathy. A number of genes have been implicated and have biological plausibility based on their involvement with the pharmacokinetics or pharmacodynamics of statins or other lipid-lowering medications. The level of confidence and replication of these findings varies, although several associations are likely true. Novel classes of lipid-lowering therapy have opened up new possibilities in the treatment of severe inherited forms of dyslipidemia, making the identification of such mutations an important pharmacogenetic predictor of failure of standard therapy, with potential response to novel therapy. Advances in next-generation sequencing technology bring the application of pharmacogenetics even closer to routine clinical practice.
authors.affiliation: Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. Jeffrey.alfonsi@lhsc.on.ca.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Alfonsi
authors.affiliation: Department of Medicine and Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hegele
authors.affiliation: Department of Medicine, Schulich School of Medicine and Dentistry, Western University, 339 Windermere Road, London, ON, Canada, N6A 5A5. steven.gryn@lhsc.on.ca.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Gryn
mesh_terms: D006720:Homozygote; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000235:genetics*; D000960:Hypolipidemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D008074:Lipoproteins / Q000235:genetics / Q000378:metabolism
chemical_list: D000960:Hypolipidemic Agents; D008074:Lipoproteins
keywords: Dyslipidemias; Hydroxymethylglutaryl-CoA reductase inhibitors; Hypolipidemic agents; Pharmacogenetics