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Liver and Statins: A Critical Appraisal of the Evidence

[ Vol. 25 , Issue. 42 ]

Author(s):

Anna Licata*, Antonina Giammanco, Maria Giovanna Minissale, Salvatore Pagano, Salvatore Petta and Maurizio Averna   Pages 5835 - 5846 ( 12 )

Abstract:


Adverse drug reactions (ADRs) represent an important cause of morbidity and mortality worldwide. Statins are a class of drugs whose main adverse effects are drug-induced liver injury (DILI) and myopathy. Some of these may be predictable, due to their pharmacokinetic and pharmacodynamic properties, while others, unfortunately, are idiosyncratic. Genetic factors may also influence patient susceptibility to DILI and myopathy in the case of statins. This review will first discuss the role of statins in cardiovascular disease treatment and prevention and the underlying mechanisms of action. Furthermore, to explore the susceptibility of statin-induced adverse events such as myopathy and hepatotoxicity, it will then focus on the recent Genome-Wide Association Studies (GWAS) concerning the transporter genes, Cytochrome P450 (CYP), organic anion-transporting polypeptide (OATP) and ABCB1 and ABCC1, which seem to play a role in the development of clinically relevant adverse events. Finally, we appraise the evidence for and against the use of statins in metabolic syndrome and in HCV-infected patients, in terms of their safety and efficacy in cardiovascular events.

Keywords:

Statins, liver damage, genetic susceptibility, single nucleotide polymorphisms (SNPs), MetS, HCV.

Affiliation:

Sezione di Gastroenterologia ed Epatologia, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Sezione di Medicina Interna e Malattie Metaboliche, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Sezione di Gastroenterologia ed Epatologia, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Sezione di Medicina Interna e Malattie Metaboliche, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Sezione di Gastroenterologia ed Epatologia, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Sezione di Medicina Interna e Malattie Metaboliche, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo



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