Abstract
PURPOSE: Dyslipidemia is a prevalent condition in the Pakistani population, significantly contributing to coronary heart disease (CHD). Atorvastatin, a widely used hypolipidemic drug, exhibits variable efficacy and safety influenced by genetic factors. This study aimed to assess the impact of SLCO1B1 rs2306283 (A > G) polymorphism on the efficacy and safety profile of atorvastatin in the Pakistani population. MATERIALS/METHODS: One hundred dyslipidemic patients, aged 40–75, received atorvastatin 10 mg daily for one month. Blood samples were collected on days 0 and 28 to measure lipid profiles and creatinine kinase (CK). Genotyping for rs2306283 (388 A> G) polymorphism was performed, and myopathy was evaluated using the Statin Associated Muscle Symptoms (SAMS) clinical index tool and CK levels. RESULTS: The minor allele frequency of rs2306283 was 12%. Only the AA (76%) and AG (24%) genotypes were observed; the GG genotype was absent. Atorvastatin significantly improved lipid parameters; however, no association was observed between rs2306283 polymorphism and lipid-lowering efficacy. A significant association was found with myopathy, with an incidence of 18.4% in patients with the AA genotype and 0% in those with the AG genotype. The G allele demonstrated a protective effect, as it was completely absent in the myopathy group. No significant elevation in CK levels was associated with myopathy. CONCLUSIONS: The SLCO1B1 rs2306283 polymorphism does not affect atorvastatin’s lipid-lowering efficacy; however, individuals with the AG genotype exhibit a significantly reduced risk of statin-induced myopathy in the Pakistani population. These findings support the potential role of pharmacogenetic screening in enhancing the safety of statin therapy. CLINICALTRIALS.GOV IDENTIFIER: NCT06674044, Date: 03/09/2024.