Statin therapy: time for a precision medicine approach?

Introduction: Statins are beneficial for both primary and secondary prevention of cardiovascular disease in many patients at elevated risk. However, selection of patients most likely to respond and least likely to have adverse effects can benefit from refinement. While pharmacogenomic aspects of statins have been thoroughly evaluated, as yet there has been no major impact on patient care, although there is great potential that a precision medicine approach might one day enhance patient care.Areas covered: This paper provides a brief overview of genetic variants that influence statin responsiveness, together with newer information on genetic risk scores that combine numerous common DNA variants into a stronger prediction of cardiovascular risk reduction from statins. We also discuss a pharmacokinetic-based approach to aid in prediction and prevention of statin adverse effects.Expert commentary: While individual genetic variants appear to have statistically significant effects on lipid lowering by s...