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SLCO1B1 gene-based clinical decision support reduces statin-associated muscle symptoms risk with simvastatin

    Amanda Massmann

    *Author for correspondence: Tel.: +1 605 404 4266;

    E-mail Address: amanda.massmann@sanfordhealth.org

    Sanford Imagenetics, Sanford Health, Sioux Falls, SD 57105, USA

    Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD 57069, USA

    ,
    Joel Van Heukelom

    Sanford Imagenetics, Sanford Health, Sioux Falls, SD 57105, USA

    Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD 57069, USA

    ,
    Robert C Green

    Department of Medicine, Brigham & Women's Hospital & Harvard Medical School, Boston, MA 02115, USA

    Ariadne Labs, Boston, MA 02215, USA

    Broad Institute of Harvard & MIT, Cambridge, MA 02142, USA

    ,
    Catherine Hajek

    Sanford Imagenetics, Sanford Health, Sioux Falls, SD 57105, USA

    Helix OpCo, LLC, San Mateo, CA 94401, USA

    ,
    Madison R Hickingbotham

    PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA

    ,
    Eric A Larson

    Sanford Imagenetics, Sanford Health, Sioux Falls, SD 57105, USA

    Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD 57069, USA

    ,
    Christine Y Lu

    PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA

    Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA

    ,
    Ann Chen Wu

    PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA

    Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA

    ,
    Emilie S Zoltick

    PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA

    ,
    Kurt D Christensen‡

    Broad Institute of Harvard & MIT, Cambridge, MA 02142, USA

    PRecisiOn Medicine Translational Research (PROMoTeR) Center, Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA

    Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA

    ‡Contributed equally as co-senior authors

    Search for more papers by this author

    &
    April Schultz‡

    Sanford Imagenetics, Sanford Health, Sioux Falls, SD 57105, USA

    Department of Internal Medicine, University of South Dakota School of Medicine, Vermillion, SD 57069, USA

    ‡Contributed equally as co-senior authors

    Search for more papers by this author

    Published Online:https://doi.org/10.2217/pgs-2023-0056

    Background:SLCO1B1 variants are known to be a strong predictor of statin-associated muscle symptoms (SAMS) risk with simvastatin. Methods: The authors conducted a retrospective chart review on 20,341 patients who had SLCO1B1 genotyping to quantify the uptake of clinical decision support (CDS) for genetic variants known to impact SAMS risk. Results: A total of 182 patients had 417 CDS alerts generated, and 150 of these patients (82.4%) received pharmacotherapy that did not increase risks for SAMS. Providers were more likely to cancel simvastatin orders in response to CDS alerts if genotyping had been done prior to the first simvastatin prescription than after (94.1% vs 28.5%, respectively; p < 0.001). Conclusion: CDS significantly reduces simvastatin prescribing at doses associated with SAMS.

    Papers of special note have been highlighted as: • of interest

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