Preeclampsia--a glimpse into the future?
نویسندگان
چکیده
n engl j med 359;8 www.nejm.org august 21, 2008 858 ulate that SLCO1B1 variants cause a susceptibility to statin-induced myopathy, but the study by the SEARCH Collaborative Group shows an unequivocal association. Since approximately 60% of the cases of simvastatin-induced myopathy were attributed to variant SLCO1B1, avoiding the administration of high-dose simvastatin to those who are homozygous or heterozygous for the variant allele (about 30% of the population analyzed by the SEARCH group) could reduce the incidence of myopathy by nearly 60%. Alternatively, one might choose to avoid prescribing simvastatin only to those who are homozygous for the risk allele (nearly 2% of the population analyzed by the SEARCH group), which could reduce the incidence of myopathy by 25%, and prescribe a relatively low dose of the drug to patients who are heterozygous for the risk allele. Further investigation is required to identify the optimal therapeutic approach. The degree of myopathy that occurred in these two trials was mild and reversible, in stark contrast to a form of statin-induced rhabdomyolysis that involves severe muscle damage accompanied by toxic effects in other organs such as the kidney. SLCO1B1 variants must be tested for an association with this adverse drug reaction as soon as possible. However, severe adverse drug reactions are very rare, and the incidence of statininduced rhabdomyolysis is reported to be as low as 0.000044 event per person per year.13 Hence, a global network for the collection of data on persons with statin-induced rhabdomyolysis would be required to test for the association with a variant in SLCO1B1. Indeed, a global mechanism for collecting data on patients with severe adverse drug reactions would benefit the field of pharmacogenetics enormously and encourage the development of new technologies.14 No potential conflict of interest relevant to this article was reported.
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ورودعنوان ژورنال:
- The New England journal of medicine
دوره 359 8 شماره
صفحات -
تاریخ انتشار 2008