Frontiers in pharmacology
Liver enzyme elevations during statin-ezetimibe therapy in ABCG2 c.421C>A variant carriers: a case series and narrative review
Door Šimičević L, Ganoci L, Karačić E en 4 anderen.
Inhoud in het Engels
Abstract
Introduction
Statin-ezetimibe combination therapy is widely used and generally well tolerated; however, liver enzyme elevations may occur during treatment and can be difficult to interpret in patients with polypharmacy and other contributing factors. The potential role of drug-drug-gene interactions (DDGIs) in this context remains insufficiently explored.
Materials and methods
We present a series of 11 patients from the PGx-CardioDrug study, selected for documented liver enzyme elevations during statin-ezetimibe therapy that led to treatment modification and carriage of the ABCG2 c.421A allele. Clinical characteristics, treatment history, laboratory findings, and outcomes were reviewed alongside available pharmacogenetic results for genes involved in drug transport and metabolism. Available records of five additional ABCG2 c.421CA carriers with documented normal liver enzyme findings during combination therapy were reviewed for descriptive comparison. A narrative review of the literature was conducted to provide a mechanistic interpretation for the observed findings.