Clinical evidence of pharmacogenetics of statins: systematic literature review

Objectives A systematic review was conducted to explore the clinical evidence of pharmacogenetic testing with statins in a personalised approach to minimise the incidence of adverse drug reaction (ADR), ensure better response and optimise medication adherence. Methods Systematic literature review using PubMed and EMBASE/Medline database that includes all clinically relevant pharmacogenomic studies involving statins. Key findings Twenty-four articles were evaluated for a total of 120 articles screened. The included studies were classified according to study design (two randomised controlled trial studies (RCTs), three meta-analysis studies, two interventional studies, four prospective studies, 10 case-control studies, two cross-sectional studies and one data analysis study). There were 23 different genetic polymorphisms related to statins were studied clinically with the specified outcome either LDL-lowering response or adverse drug reaction. Those genes were diverse and involve metabolic enzymes, transporters and other receptors. Conclusions Many studies suggest a strong association between clinical outcomes and certain genes relevant to statins. However, these studies were observational and only a few were randomised controlled trials (RCTs). The strength of evidence to support pharmacogenetic testing for statin is not adequate.