SLCO1B1

There's other applications, including pharmacogenomics and looking at whether or not you're gonna respond favorably or unfavorably to a drug or medication or intervention, and that's very clinically relevant.

You know, um, statins, one of the most prescribed drugs and medications in the world, there's a certain genetic, uh, genotype, SLCO1B1, that's associated with being statin intolerant, and that risk for myopathy is increased.

So very important, you know, for all those folks that are out there, and they're like, "Hey, I started a statin, and unfortunately, like my-- I-- fatigue and muscle and all..." Very important clinical molecular association that's not oftentimes looked at.

And there are other, you know, nutrigenomic, uh, clinical applications in looking at how your genes responds to micronutrients and how micronutrients respond to your genes.

Most clinicians have never opened one.

Concrete examples: SLCO1B1 encodes a transporter that moves statins into the liver.

Reduced function variants mean the drug lingers in circulation and in muscle instead, and muscle exposure is what produces statin myopathy.

There is a large population walking around convinced they are statin intolerant who are in fact intolerant of that statin at that dose and would do perfectly well on a different agent.

Two previous statin attempts, both abandoned for muscle pain.

She had concluded she was statin intolerant, and her previous physicians had accepted that.

ApoB elevated, LPA elevated, pharmacogenomics, SLCO1B1 reduced function variant.

She was not statin intolerant.

It's a new drug, so we don't have a lot of real-world data, but there are precautions with either strong or moderate 3-4 inducers or inhibitors.

It also inhibits P-glycoprotein, MATE1, MATE2K, OCT1, OCT2, OATP1B1, OATP1B3, breast cancer resistant protein, and BSEP, which is a transport protein I've never heard of.

So it does inhibit a lot of other transporters and has a risk for other interactions.

This inhibition of, like I say, OCT2 and MATE1 is probably why you see creatinine increased in 52%.