TY - JOUR T1 - Pharmacogenomics of statin-related myopathy: Meta-analysis of rare variants from whole-exome sequencing. JF - PLoS One Y1 - 2019 A1 - Floyd, James S A1 - Bloch, Katarzyna M A1 - Brody, Jennifer A A1 - Maroteau, Cyrielle A1 - Siddiqui, Moneeza K A1 - Gregory, Richard A1 - Carr, Daniel F A1 - Molokhia, Mariam A1 - Liu, Xiaoming A1 - Bis, Joshua C A1 - Ahmed, Ammar A1 - Liu, Xuan A1 - Hallberg, Pär A1 - Yue, Qun-Ying A1 - Magnusson, Patrik K E A1 - Brisson, Diane A1 - Wiggins, Kerri L A1 - Morrison, Alanna C A1 - Khoury, Etienne A1 - McKeigue, Paul A1 - Stricker, Bruno H A1 - Lapeyre-Mestre, Maryse A1 - Heckbert, Susan R A1 - Gallagher, Arlene M A1 - Chinoy, Hector A1 - Gibbs, Richard A A1 - Bondon-Guitton, Emmanuelle A1 - Tracy, Russell A1 - Boerwinkle, Eric A1 - Gaudet, Daniel A1 - Conforti, Anita A1 - van Staa, Tjeerd A1 - Sitlani, Colleen M A1 - Rice, Kenneth M A1 - Maitland-van der Zee, Anke-Hilse A1 - Wadelius, Mia A1 - Morris, Andrew P A1 - Pirmohamed, Munir A1 - Palmer, Colin A N A1 - Psaty, Bruce M A1 - Alfirevic, Ana AB -

AIMS: Statin-related myopathy (SRM), which includes rhabdomyolysis, is an uncommon but important adverse drug reaction because the number of people prescribed statins world-wide is large. Previous association studies of common genetic variants have had limited success in identifying a genetic basis for this adverse drug reaction. We conducted a multi-site whole-exome sequencing study to investigate whether rare coding variants confer an increased risk of SRM.

METHODS AND RESULTS: SRM 3-5 cases (N = 505) and statin treatment-tolerant controls (N = 2047) were recruited from multiple sites in North America and Europe. SRM 3-5 was defined as symptoms consistent with muscle injury and an elevated creatine phosphokinase level >4 times upper limit of normal without another likely cause of muscle injury. Whole-exome sequencing and variant calling was coordinated from two analysis centres, and results of single-variant and gene-based burden tests were meta-analysed. No genome-wide significant associations were identified. Given the large number of cases, we had 80% power to identify a variant with minor allele frequency of 0.01 that increases the risk of SRM 6-fold at genome-wide significance.

CONCLUSIONS: In this large whole-exome sequencing study of severe statin-related muscle injury conducted to date, we did not find evidence that rare coding variants are responsible for this adverse drug reaction. Larger sample sizes would be required to identify rare variants with small effects, but it is unclear whether such findings would be clinically actionable.

VL - 14 IS - 6 ER -