Approach to clinical and genetic characterization of statin-induced myopathy

HMG CoA reductase inhibitors (statins) are among the most commonly prescribed medications in the industrialized world. They are generally regarded as safe. Mild myalgias can occur in up to 10 % of patients exposed to statins, but skeletal muscle damage (accompanied by an increase in circulating creatine kinase levels) occurs much less frequently. Clinical predictors of statin-induced rhabdomyolysis (severe muscle damage with end organ failure) include female gender, advanced age, and concomitant medications known to interact with critical pharmacokinetic and pharmacodynamic processes. The influence of genetic variations has been investigated by candidate gene association studies, genome-wide association studies, and whole-genome sequencing. This chapter summarizes current available approaches to clinical and genetic characterization of statin-related adverse effect.