Gene Behind Serious Statin Risk

[cjbrooksjc]

NOW YOU TELL ME!
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Gene Behind Serious Statin Risk
Muscle Condition From Cholesterol Drugs Linked to Gene Variant
By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 20, 2008 -- A variant gene causes more than 60% of cases of a serious side effect of cholesterol-lowering statin drugs -- muscle pain and weakness.

Statin drugs -- Lipitor, Pravachol, Crestor, Lescol, Mevacor, and Zocor -- are considered remarkably safe. But one in every 10,000 patients per year develops drug-related muscle trouble. Very rarely, this myopathy leads to muscle breakdown and fatal kidney failure.

Oxford University researcher Rory Collins, MB, and the SEARCH Collaborative Group performed genome-wide scans of heart attack survivors taking high doses (80 mg/day) of Zocor in a large-scale clinical trial. They compared the 98 patients who developed myopathy with 98 patients who did not.

"We provide compelling evidence that at least one common variant in the SLCO1B1 gene substantially alters the risk of [Zocor]-induced myopathy," Collins and colleagues conclude. "These findings are likely to apply to other statins because myopathy is a class effect, and SLCO1B1 polymorphisms affect the blood levels of several statins."

The gene variant is relatively common. It alters the function of a gene that regulates drug uptake in the liver. People who inherit two copies of the gene had a 17-fold increased risk of muscle problems when taking high doses of Zocor. Those with just a single copy had a 4.5-fold increased risk.

Collins and colleagues suggest that before starting high-dose statin treatment, patients may benefit from genetic testing to see whether they are at risk of side effects.

Yusuke Nakamura, MD, PhD, director of the Human Genome Center at the University of Tokyo, agrees.

In an editorial accompanying the Collins team's report in the Aug. 21 issue of the New England Journal of Medicine, Nakamura suggests that avoiding high doses of statins in people who carry the gene could reduce statin-related muscle problems by 60%.

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Hope you find this as enlightening as I did.

Brooks

[Ray Holder]

Footnote to Rory Collins

If you google Rory Collins, among the results you will find that Pfizer awarded him £50,000 for " life saving research into heart attacks etc" in 2004.

He had a major part in setting up the guidelines at about the same time for NICE, which led to the use of statins in large quantities in UK. He has been in the press etc strongly advocating the use of statins.

Hardly an unbiassed researcher, the award could even be construed as an incentive or reward for services rendered.

Ray

[Biologist]

As soon as I read the following, I knew, without doubt, he was 100% Bought & Paid For:

"Statin drugs -- Lipitor, Pravachol, Crestor,
Lescol, Mevacor, and Zocor -- are considered
remarkably safe. But one in every 10,000
patients per year develops drug-related
muscle trouble. Very rarely, this myopathy
leads to muscle breakdown and fatal kidney
failure."

I have no respect for him whatsoever. He is nothing.

Biologist

[Biologist]

Whether the "he" cited above is Daniel J. DeNoon, the writer of the piece, or the Collins, who is quoted, I am not sure. I'm unimpressed with both.

Biologist

[Ray Holder]

When I first read this post, I saw the name Collins, and that got me going to start with. I am not much into genes, but later thought, its all part of the "statins are so very safe" doctrine, trying to put the blame for side effects on the patient, for having the wrong genes, while the known basic reasons for statin damage are never acknowledged. Q10 and carnitine supply damage do not appear anywhere in the Oxford literature on statins, in fact Q10 is not mentioned in the guidelines papers, its existence is not recognised at all.

All part of the strategy of praising the wonderful statins, and trying to keep the public unaware of the problems involved. Even though they quote muscle pain as being very rare, 1 in 10,000, they managed to find 98 affected persons, so did they have to trawl through almost a million statin takers to find them?? From personal knowledge of friends etc, I can name quite a large proportion of statin induced muscle pain sufferers, my circle of friends is not in thousands, more like hundreds, but Oxford researchers seem to be enclosed in one way glass windows, and they cannot see that the 20% getting pain, although anecdotal to them, are very real outside the city walls.

The government body, the Medical Research Council, seem to be closely associated with the acadenic bodies in Oxford, the large MRC/HPS trial of statins was a joint effort, I suspect a lot of "OLD BOY Networking" was involved, a government body should be beyond suspicion and quite separate from any commercial influence.

Ray

[Brian C.]

Hope you have all read my "Why we suffer..." posted link.

Brian.

[cjbrooksjc]

My interest in the initial post was the following:

*************(Quote) "We provide compelling evidence that at least one common variant in the SLCO1B1 gene substantially alters the risk of [Zocor]-induced myopathy," Collins and colleagues conclude. "These findings are likely to apply to other statins because myopathy is a class effect, and SLCO1B1 polymorphisms affect the blood levels of several statins."

The gene variant is relatively common. It alters the function of a gene that regulates drug uptake in the liver. People who inherit two copies of the gene had a 17-fold increased risk of muscle problems when taking high doses of Zocor. Those with just a single copy had a 4.5-fold increased risk.

Collins and colleagues suggest that before starting high-dose statin treatment, patients may benefit from genetic testing to see whether they are at risk of side effects. (Quote)**************

Regardless of Collins' fiscal intentions I think this is useful data. How expensive it may be to test for this variant is unknown to me, but SLCO1B1 is another arrow in my quiver. That some Statin users are so seriously affected while others are untouched has always been a curious anomaly for me; this helps me understand that dichotomy (potentially). Even in the jetsam there could be something useful. I caution that a knee-jerk reaction may cause you to throw the baby out with the bathwater.

Brooks

[harley2ride]

I was talking about this in my posts (not as specific) over a year ago... My docs told me over a year ago, that the crestor had tweaked my dna (flipped a gene marker), which cranked on my muscular distrophy...

[Biologist]

Brooks,

I thought the info was good. It is the apparent obligatory kissing up to Phama's financial interests that is so disappointing to me. It says a lot about what a mess they have made and are able to perpetuate without even asking.

Brian,

I just got in "Malignant Medical Myths" (where I see Dr. Graveline is not sold on the Alcohol / Heart theory -- and probably right about that) along with a whole slew of other books. I am reading it first -- I like the guy's credentials. Appears to speak with non-forked tongue. (Pardon the parochial American Indian vernacular there, if you would.) Some have to go to the "chop shop" first for "repackaging" which includes a classic physiology text book I bought second hand from Amazon for a few bucks -- normally about $100. Also got Klein's book in too. Perused it. It will be interesting I'm sure. I left off the HMG CoA Reductase book for now. $50, yes; $100, maybe later on...

adec,

Give some thought to Molecular & Cellular Biology as a career choice, or "hobby." The low hanging fruit is all over the place -- just no one is getting it. If the new or old science discovered (and there's plenty of it) does not fit the Lipid Hypothesis, or otherwise make money for Pharma, it's trashed. But it's still very real. I may have just made my first significant contribution to Medicine by connecting a few dots. It is a proposed drug delivery protocol. It appears it is now being clinically tested on a small scale. I give it 50/50 odds of working well. If it does, it will be important. Get this: It inhibits a reductase. A different one. One that needs inhibiting. But safely. More on that maybe in a few months or years...

OK, off to do some reading for a while...

But I'll be back.

Biologist

[cjbrooksjc]

Harley2: Yes, I remember that. As I recall you didn't know the ID of the gene marker; now we do. How are you doing BTW?

Brooks

[cjbrooksjc]

Harley: Just read your current status in another thread - no need to reply...

Brooks