People often ditch statins due to side effects
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By Viviane Callier
Should you take statins? The common drugs are a safe and effective way to lower cholesterol and prevent heart disease, but many of those taking them give up due to painful side effects. Furthermore, in some people, this pain may be caused by the nocebo effect, rather than the drug itself. But genetic screening could help reduce side effects and reassure people they are unlikely to feel any pain, encouraging more people to take statins.
Deepak Voora of Duke University, North Carolina, and his colleagues have been researching a gene associated with muscle pain in people taking statins. The gene encodes a protein that carries drugs into liver cells. A variant of this gene has been linked to aches in response to statins.
To find out if this variant affects what side effects someone experiences from different statins, Voora and his team reanalysed data from a clinical trial that had randomly assigned three types of this drug. They found that people with the gene variant had the highest risk of side effects when they were given a statin called simvastatin, but this risk was much lower when they took pravastatin.
The researchers then ran a trial in 159 people to see if genetic screening could help prescribe the most appropriate statin for each person. All the participants had previously stopped taking statins due to muscle pain.
First, everyone was given a genetic test, but only one group were told their results. For this group, a doctor explained whether or not their DNA put them at risk of statin-related muscle pain. Those at risk were recommended a statin that was less likely to cause side effects for their genetic variant, while those not at risk were told they could try any type.
The other participants werent told their test results, and instead received standard, generic recommendations from their doctor.
Of those told their results, around 57 per cent decided to start taking statins again within the next three months, compared with only a third of those who received generic recommendations. By the end of the eight-month study, those who knew their results had blood LDL cholesterol levels that were, on average, 10 to 15 per cent lower than the others.
Thats pretty remarkable given these were patients that were initially refusing to take statins, says Jason Vassy of Harvard Medical School.
By improving a persons perception of a drug, you can boost how many take it and keep taking it, which has been a major problem, says Voora. He hopes the approach could be extended to help doctors and patients feel more confident about other drugs. This concept of using precision medicine to address the psychology of how patients feel about drugs might be a winning combination, he says.
Read more: Statin muscle aches are all in my head? I beg to differ
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Genetic test helps people avoid statins that may cause them pain - New Scientist
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