CPIC Publishes Guideline for SLCO1B1, ABCG2, CYP2C9 and Statin Therapy

The CPIC guideline for SLCO1B1, ABCG2, and CYP2C9 and statin-associated musculoskeletal symptoms (SAMS) has been published in the journal Clinical Pharmacology and Therapeutics. This guideline is an update to the CPIC guideline for simvastatin and SLCO1B1, but now includes expanded literature review on four additional genes, ABCG2, CYP2C9, HMGCR and CYP3A4/5 and all statins. 

The guideline gives specific prescribing recommendations for: 

• simvastatin, atorvastatin, lovastatin, pravastatin and pitavastatin based on SLCO1B1 phenotype
• rosuvastatin based on SLCO1B1 and ABCG2 phenotypes 
• fluvastatin based on SLCO1B1 and CYP2C9 phenotypes 

It also provides a figure illustrating statin recommendations with preferred statin intensity and statin dose stratified by SLCO1B1 phenotype (i.e., decreased or poor function):

For therapeutic recommendations and further details, please refer to the guideline and supplemental materials on the CPIC website. Annotations of the guideline, including interactive genotype picker tool for each statin, is available on the PharmGKB website.