Clinical Trial: Pharmacoepidemiology and Pharmacogenetics of a Statin Adverse Event

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Pharmacoepidemiology and Pharmacogenetics of a Statin Adverse Event

Brief Summary: To conduct a case-control study of factors that increased the risk of rhabdomyolysis, an adverse drug reaction in cerivastatin users

Detailed Summary:

BACKGROUND:

Cerivastatin (Baycol), an HMG-CoA reductase inhibitor (statin), was approved and marketed in early 1998 for the treatment of dyslipidemias. Soon afterwards, suspected adverse drug reaction (SADR) reports in cerivastatin users often cited rhabdomyolysis, an uncommon condition in which the breakdown of skeletal muscle cells causes pain, weakness and, in-some cases, renal failure or death. By the time that cerivastatin was withdrawn from the market in 2001, the FDA had received 1,899 SADRs for rhabdomyolysis associated with cerivastatin compared to 1,440 for all other statins combined. In an analysis conducted by FDA scientists, the relative reporting rate (RRR) of fatal rhabdomyolysis was 40 times higher among users of cerivastatin than among users of other statins. For the outcome of all fatal and non-fatal rhabdomyolysis, the RRR was 54 times higher. About half of the rhabdomyolysis cases occurred in subjects who had taken both cerivastatin and gemfibrozil. Subsequently, pharmacokinetic studies demonstrated that gemfibrozil inhibits both major metabolic pathways for cerivastatin-not only the Cytochrome P-450 (CYP) 2C8-mediated oxidation, but also the glucuronidation by uridine diphosphate glucuronysyltransferases (UGT). The investigators hypothesize that rhabdomyolysis cases who were taking cerivastatin but not gemfibrozil had one or both of two types of risk factors: (1) medications that are known inhibitors of these enzymes; or (2) functional genetic variants in one or more of the CYP or UGT enzymes.

Coronary heart disease (CHD) is the leading cause of morbidity and mortality in the U.S. and statin agents are commonly employed for the treatment of hyperlipidemia, one of the principal risk factors for CHD. Given the hundreds of thousands to millions of Americans presently on statin therapy, and the potentially
Sponsor: University of Washington

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Information By: University of Washington

Dates:
Date Received: October 17, 2005
Date Started: September 2005
Date Completion:
Last Updated: January 4, 2012
Last Verified: January 2012