{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:38:21Z","timestamp":1787701101557,"version":"build-2784847793"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T00:00:00Z","timestamp":1741219200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>\n                    Statin pharmacogenetic implementation guidelines are derived from evidence of primarily Eurocentrically biased study populations. Functional\n                    <jats:italic>SLCO1B1<\/jats:italic>\n                    variants that are rare in these study populations have not been equitably investigated and are thus missing from guidelines. The objective of this precision medicine health equity study was to determine the clinical validity of understudied candidate functional\n                    <jats:italic>SLCO1B1<\/jats:italic>\n                    variants common in people with 1,000 Genomes sub\u2010Saharan African superpopulation (1KG\u2010AFR\u2010like) genetic similarity. We conducted our analyses using the real\u2010world evidence of participants from three large, electronic health record\u2010linked biobanks. We used bilirubin levels (as an endogenous substrate of organic anion transporting polypeptide [OATP1B1] function) and severe statin\u2010induced myotoxicity phenotypes. Loss\u2010of\u2010function splice variant rs77271279 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20091.1\u2009\u00d7\u200910\n                    <jats:sup>\u221217<\/jats:sup>\n                    ) had the strongest association with elevated total bilirubin levels in Black participants (mean 84% AFR\u2010like genetic similarity) followed by missense variant rs59502379 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20097.4\u2009\u00d7\u200910\n                    <jats:sup>\u221212<\/jats:sup>\n                    ) then missense variant rs4149056 (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20096.0\u2009\u00d7\u200910\n                    <jats:sup>\u22125<\/jats:sup>\n                    ). In an exploratory subset of the Black study population who used statins (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200977 severe statin\u2010induced myotoxicity cases), rs59502379 (odds ratio [OR]\u2009=\u20092.85, 95% confidence interval [CI] 1.08\u20137.52), but not rs77271279 (OR\u2009=\u20091.75, 95% CI 0.62\u20134.73) was associated with myotoxicity. Sensitivity analyses in participants with &gt;5% AFR\u2010like genetic similarity corroborated these findings. For white participants, rs77271279 and rs59502379 were rare precluding subsequent analyses. Our findings highlight the clinical relevance for understudied\n                    <jats:italic>SLCO1B1<\/jats:italic>\n                    variants on pharmacogenetic testing panels with a potential immediate impact on reducing the risk of severe statin\u2010induced myotoxicity primarily in Black patients, a group historically excluded from genomic research. Future studies require larger statin user study populations with less heterogeneity by statin type.\n                  <\/jats:p>","DOI":"10.1002\/cpt.3624","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T17:14:10Z","timestamp":1741713250000},"page":"1696-1705","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["<i>SLCO1B1<\/i>\n                    Functional Variants, Bilirubin, Statin\u2010Induced Myotoxicity, and Recent Sub\u2010Saharan African Ancestry: A Precision Medicine Health Equity Study"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-1230","authenticated-orcid":false,"given":"Tanushree","family":"Haldar","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-4878","authenticated-orcid":false,"given":"Mark","family":"Kvale","sequence":"additional","affiliation":[{"name":"Institute for Human Genetics University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3992-4070","authenticated-orcid":false,"given":"Jia","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Bioengineering and Therapeutic Sciences University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8517-6678","authenticated-orcid":false,"given":"Michael P.","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-5340","authenticated-orcid":false,"given":"Willow","family":"Coyote\u2010Maetas","sequence":"additional","affiliation":[{"name":"Department of Bioengineering and Therapeutic Sciences University of California San Francisco  San Francisco California USA"},{"name":"Quantitative Biosciences Institute University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3226-4727","authenticated-orcid":false,"given":"Linda","family":"Kachuri","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Stanford University  Stanford California USA"},{"name":"Stanford Cancer Institute Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0146-1434","authenticated-orcid":false,"given":"John S.","family":"Witte","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health Stanford University  Stanford California USA"},{"name":"Stanford Cancer Institute Stanford University School of Medicine  Stanford California USA"},{"name":"Department of Biomedical Data Science and Genetics Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Iribarren","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Pleasanton California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3631-0129","authenticated-orcid":false,"given":"Marisa W.","family":"Medina","sequence":"additional","affiliation":[{"name":"Institute for Human 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