Personalized DNA tests identify patients at risk for adverse side effects
LONDON, ON – Statins, a class of drugs used to lower cholesterol, are among the best selling drugs in North America and around the world. However, statin myopathy, which results in muscle pain and weakness, is a common side effect affecting up to 10 percent of statin users. A recent study led by Dr. Richard Kim of the Lawson Health Research Institute, in collaboration with Dr. Robert Hegele of Robarts Research Institute, and researchers from Vanderbilt University, found that commonly occurring genetic variations in a person's genes could put them at risk for statin-associated muscle injury.
Nearly 3-million Canadians are currently taking a statin. However, according to Dr. Kim, who is a physician at London Health Sciences Centre (LHSC) and holds the Wolfe Medical Research Chair in Pharmacogenomics at Western University, little is known about the blood levels of these drugs in a real world patient population. "Currently, we do not fully understand the drug exposure necessary for optimal statin therapy, making it difficult to predict an individual's dose requirement while minimizing the risk of side effects," states Dr. Kim. In his recent study, Dr. Kim set out to quantify patient's blood levels of statins and decipher the role genes play in statin uptake and absorption.
"We found that commonly occurring genetic variations in the genes that help to clear the drugs from the body, widely referred to as drug transporters, are key predictors of patients who will likely have high statin blood levels," says Dr. Kim. "We think those patients with high levels of statins in their blood are at a much greater risk for statin-associated muscle injury."
Currently, physicians can not readily identify at risk patients using the available clinical tests. However, Dr. Kim proposes using the pharmacogenetic tests presently available, in addition to the clinical variables he and his research team have outlined in their paper, would help to better identify these patients and prevent serious side effects. "This seems to be very relevant, especially for the many elderly patients who take these medications," says Dr. Kim.
As part of their personalized medicine program, Dr. Kim plans to utilize these pharmacogenetic tests and the algorithm they have created and apply them in a hospital and region wide fashion. As well, a larger clinical trial is being planned to compare their genomics-guided approach versus standard care in terms of better outcomes, cost-effectiveness, and prevention of adverse drug reactions.
The study, "Clinical and Pharmacogenetic Predictors of Circulating Atorvastatin and Rosuvastatin Concentration in Routine Clinical Care," was published in the July issue of Circulation: Cardiovascular Genetics.
http://www.eurekalert.org/pub_releases/2013-08/lhri-rli080613.php
Graham
17 comments:
Thanks Graham. This sounds like very good news. I am always heartened by any moves owards treating people as individuals just as I am horrified by calls for mass medication. of the healthy population.
Here's another way of lessening the danger of these drugs; don't take them.
Best
Dillinger
"Here's another way of lessening the danger of these drugs; don't take them."
Agree 100% !
Eddie
Highly recommended read
Jeff
I also agree, to lessen any danger do not take them. In my experience side effects from taking statins were bad.
Sheila
Please read this post from Dr Davis' blog, wheat belly.
He explains how eliminating carbohydrates from the diet easily normalises blood triglycerides without any medication.
Cholesterol is not the problem - it's the small low density lipoprotein PARTICLES once they have been depleted of triglycerides and cholesterol that cause atherosclerosis.
http://www.wheatbellyblog.com/2012/12/cholesterol-belly/
My father in law eats a high carb diet and has been on statins for years. He now has ALzheimer's disease - yes, the brain is composed of cholesterol and the statins have basically eaten up his brain. Read this research article which clearly demonstrates how statins cause this.
http://people.csail.mit.edu/seneff/alzheimers_statins.html
Why not simply take 100mgs of CoQ10 with the statin? That will virtually eliminate the problem caused?
@Lisa - you said "Cholesterol is not the problem - it's the small low density lipoprotein PARTICLES once they have been depleted of triglycerides and cholesterol that cause atherosclerosis."
Then what say you with regard to Jimmy Moore's last blood work??
http://livinlavidalowcarb.com/blog/jimmy-moores-cholesterol-test-results-2008-2013/18256
A/O 4/18/13 his LDL-P was 2730 and his Small LDL-P was 478.
From 10/25/12 to 4/18/13 his Small LDL-P INCREASED from 221 to 478.
SO - according to Dr Davis does Jimmy have a problem??
Statins are a curse and pretty much useless for most people. There is no correlation between total cholesterol numbers and heart attacks and stroke. Are you proposing we take a pill that benefits almost no one, and then take another pill to counteract the side effects of a pill most derive no benefit from. I will pass on the statins.
Eddie
@Lisa
http://www.wheatbellyblog.com/2012/12/cholesterol-belly/
Dr. Davis says:
July 28, 2013 at 4:12 pm
The bulk of data suggest that small, oxidation-prone, glycation-prone is a much more atherogenic beast than large LDL. This study is just one among many.
We do indeed need better data, particularly real outcome studies (myocardial infarction, mortality), not just surrogate studies. But the surrogate study data on the whole suggest that small LDL particles are the worst kind.
The full study mentioned
http://www.nypcvs.org/images/MESA.pdf
So I ask again - doesn't Jimmy's blood work indicated that his VLCHF diet may be causing problems in that it is not reducing his Small LDL-P to levels that are not problematic?
@Eddie
that is not an answer to the question I posed with regards to JM. Also - supplementing with CoQ10 is recommended by people such as Guyenet
http://wholehealthsource.blogspot.com/2009/07/diet-heart-hypothesis-oxidized-ldl-part.html
http://wholehealthsource.blogspot.com/2009/08/diet-heart-hypothesis-oxidized-ldl-part.html
CoQ10 has a special relationship with cardiovascular health. Levels are reduced in individuals with cardiovascular disease and high oxLDL. Whether this is cause or effect, it's difficult to say. However, supplementing with CoQ10 has been repeatedly shown to be effective for high blood pressure and congestive heart failure. There has been one controlled trial of CoQ10 (120 mg/day) supplementation for the prevention of heart attacks, which reduced cardiac events including deaths by 45%, compared to a group receiving B vitamins. The CoQ10 group showed a large reduction in plasma lipid oxidation. This is a promising result and the experiment should be repeated.
CoQ10 is not an essential nutrient, although food does contribute a small portion of our total CoQ10 use. The large majority of CoQ10 is synthesized by the body itself, and this is dependent on a number of essential nutrients, including vitamin B2, B3, B5, B6, B12, vitamin C and folic acid. Thus, the body's synthesis of CoQ10 is dependent on overall nutritional status. Sub-clinical deficiency of any of these vitamins can hypothetically contribute to reduced CoQ10 production and thus oxLDL. This is potentially a big problem since modern Americans get more than half their calories from nutrient-poor refined foods. Liver is the single best source of many of these vitamins, and also holds the title of Most Nutritious Food on the Planet. It's also rich in CoQ10.
CoQ10 synthesis declines with age and is reduced in people with disorders involving oxidative stress, like cardiovascular disease. It's also greatly reduced by the cholesterol-lowering drugs statins. I'm not generally in favor of supplements, but CoQ10 seems to have a lot of promise and nothing but positive side effects that I'm aware of. CoQ10 deficiency may be a common theme in a number of modern disorders.
"SO - according to Dr Davis does Jimmy have a problem?"
Why don't you ask Jimmy Charles ? Maybe you can't because you spent so much time up Evie's arse, you had your zip code on the soles of your boots, you have some nerve.
Jimmy is a friend of ours and you aided and abetted Evie in rubbishing him. We have a bit of loyalty here mate.
Eddie
"that is not an answer to the question I posed with regards to JM"
It's the only answer you will be getting from me.
BTW has Evie banned you again ?
Eddie
@Eddie - you have you face so far up your own ass you can't see the light!!
If a VLCHF diet is SO HEALTHY why are Jimmy's blood lipids so bad??
BTW - Dr Thomas Dayspring - when interviewed by JM - told him that his LDL P was so elevated that he should immediately reduce the saturated fat - get retested in 30 days and if the levels didn't start to decline he should immediately start on a statin drug!!
SO - if he was REALLY a friend of yours you should be VERY concerned with regard to what DRs Dayspring abd Davis have said with regard to small LDL-P
BTW - if someone deserved to be rubbished they will be rubbished!!
Charles if you want to have a go at Jimmy Moore please do it elsewhere. We fully appreciate you are one of worlds leading intellectuals and a master at wasting peoples time. I have not got the time to play cut and paste with you. If you like statins so much I suggest you take them. You know full well what we think of statins here, and that we have found our salvation with a lowcarb high fat diet. Come back all day long and keep pushing our page views up, but you are in the wrong place to flog statins and cast doubt on our dietary lifestyle.
Eddie
Charles Grashow said..
If a VLCHF diet is SO HEALTHY why are Jimmy's blood lipids so bad??
In my experience and that of many other VLCHF has made improvements in blood lipids, trigs have in many cases been dramatically lowered and big increases in HDL is the norm.
As for Jimmy only he can answer your question, he is an affable chap I'm sure he will answer your query I'll even supply a live link to his blog for you: http://livinlavidalowcarb.com/blog/
Why not simply take 100mgs of CoQ10 with the statin? That will virtually eliminate the problem caused?
Easier still don't take the statins and you have no problem in the first place simples.
Charles I suggest you take the statins and stick them were the sun don't shine.
Kind regards
Graham
It’s unlikely that the target group here, the very elderly will be consulted to any meaningful extent about the prescription of statins. They are probably very unlikely to refuse them in any event. That being the case, it must surely be a good thing to try to identify those who are most likely to be adversely affected. I know , I know, Damage limitation. In the process of researching this aspect its surely possible that useful information will be discovered possibly restricting the present tendency to prescribe them generally and non-specifically. Even the very fact of such a study is a hopeful sign. An admission that there are considerable problems with these drugs. And I see myself as a pessimist!
Kath
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