rs4149056

This is a missense variant in the SLCO1B1 gene.

Key Literature Trait Associations

Statin Myopathy Risk

SLCO1B1*5 (V174A) reduces function of the OATP1B1 hepatic uptake transporter, decreasing hepatic clearance of statins and increasing systemic exposure. Homozygous CC carriers have a 17-fold increased risk of simvastatin-induced myopathy. CPIC recommends avoiding simvastatin >20 mg or switching to alternative statins (rosuvastatin, pravastatin) in *5 carriers. The landmark SEARCH trial finding (PMID 18650507) led to FDA simvastatin label updates.

Link E et al. SLCO1B1 variants and statin-induced myopathy--a genomewide study. The New England Journal of Medicine 359(8):789-799 (2008)
Allele C
OR 4.50
p 5.0e-19
Large GWAS

Statin-Induced Myopathy

The C allele of SLCO1B1*5 (Val174Ala) reduces function of the OATP1B1 hepatic uptake transporter, impairing statin clearance from the bloodstream and increasing muscle exposure. In the SEARCH trial, each copy of the C allele conferred a 4.5-fold increased risk of simvastatin-induced myopathy, with CC homozygotes at ~18-fold risk. CPIC guidelines recommend lower simvastatin doses or alternative statins for carriers.

Link E et al. SLCO1B1 variants and statin-induced myopathy--a genomewide study. The New England Journal of Medicine 359(8):789-799 (2008)
Allele C
OR 4.50
p 4.0e-9
Large GWAS

GWAS Catalog Trait Associations (146)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

glycochenodeoxycholate glucuronide (1) measurement

Allele T
OR 0.85
p
N 14,296
Large GWAS
European
Allele T
OR 0.89
p
N 8,236
Large GWAS
European
Allele T
OR 1.01
p
N 6,136
Large GWAS
European
Feofanova EV et al. Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. Nature Communications 14(1):3111 (2023)
Allele T
OR 0.98
p 5.0e-303
N 6,053
Large GWAS
multi-ancestry
Allele T
OR 1.07
p 3.0e-266
N 4,574
Large GWAS
European

glycocholenate sulfate measurement

Allele T
OR 0.56
p
N 14,296
Large GWAS
European
Feofanova EV et al. Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. Nature Communications 14(1):3111 (2023)
Allele T
OR 0.61
p 3.0e-150
N 9,016
Large GWAS
multi-ancestry
Allele T
OR 0.61
p 4.0e-209
N 8,250
Large GWAS
European
Allele T
OR 0.66
p 1.0e-187
N 6,136
Large GWAS
European
Allele T
OR 0.46
p 8.0e-126
N 4,959
Large GWAS
European

isoleucine-to-X-11529 ratio

Shin SY et al. An atlas of genetic influences on human blood metabolites. Nature Genetics 46(6):543-550 (2014)
Allele T
OR 0.30
p
N 5,086
Large GWAS
European

X-11905 measurement

Allele T
OR 0.58
p
N 14,296
Large GWAS
European

X-11529 measurement

Shin SY et al. An atlas of genetic influences on human blood metabolites. Nature Genetics 46(6):543-550 (2014)
Allele T
OR
β 0.295
p 6.0e-315
N 6,664
Large GWAS
European

tetradecanedioate measurement

Allele T
OR 0.49
p 7.0e-270
N 14,296
Large GWAS
European
Allele T
OR 0.51
p 3.0e-144
N 8,268
Large GWAS
European
Allele T
OR 0.57
p 6.0e-141
N 6,136
Large GWAS
European
Allele T
OR 0.44
p 1.0e-100
N 4,944
Large GWAS
European

hexadecanedioate measurement

Allele T
OR 0.48
p 2.0e-259
N 14,296
Large GWAS
European
Feofanova EV et al. Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. Nature Communications 14(1):3111 (2023)
Allele T
OR 0.45
p 2.0e-87
N 9,331
Large GWAS
multi-ancestry
Allele T
OR 0.52
p 5.0e-151
N 8,260
Large GWAS
European
Allele T
OR 0.57
p 6.0e-139
N 6,136
Large GWAS
European

Glycodeoxycholate sulfate measurement

Allele T
OR 0.48
p 7.0e-246
N 14,296
Large GWAS
European
Feofanova EV et al. Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. Nature Communications 14(1):3111 (2023)
Allele T
OR 0.55
p 4.0e-90
N 5,818
Large GWAS
multi-ancestry

hexadecenedioate (C16:1-DC) measurement

Allele C
OR 0.64
p 1.0e-233
N 8,248
Large GWAS
European
Allele C
OR 0.67
p 6.0e-193
N 6,136
Large GWAS
European
Allele C
OR 0.37
p 7.0e-87
N 4,959
Large GWAS
European
Feofanova EV et al. Whole-Genome Sequencing Analysis of Human Metabolome in Multi-Ethnic Populations. Nature Communications 14(1):3111 (2023)
Allele C
OR 0.57
p 1.0e-46
N 2,425
Large GWAS
multi-ancestry

X-12063 measurement

Allele T
OR 0.44
p 1.0e-222
N 14,296
Large GWAS
European
Shin SY et al. An atlas of genetic influences on human blood metabolites. Nature Genetics 46(6):543-550 (2014)
Allele T
OR
β 0.118
p 1.0e-73
N 7,197
Large GWAS
European

ClinVar annotation

Drug Response★★★★
11 submitters64 publications

not provided; Rotor syndrome; simvastatin acid response - Metabolism/PK; Gilbert syndrome; not specified; atorvastatin response - Metabolism/PK; rosuvastatin response - Metabolism/PK; simvastatin response - Toxicity; hmg coa reductase inhibitors response - Toxicity; atorvastatin response - Toxicity; simvastatin response - Metabolism/PK; lovastatin response - Toxicity; pravastatin response - Toxicity; lovastatin response - Metabolism/PK; pitavastatin response - Metabolism/PK; rosuvastatin response - Toxicity; fluvastatin response - Metabolism/PK; fluvastatin response - Toxicity; lovastatin acid response - Metabolism/PK; SLCO1B1-related disorder

View on ClinVar →

Research that mentions this SNP (13)

Correlation between single-nucleotide polymorphisms and statin-induced myopathy: a mixed-effects model meta-analysis
Meta-analysisN=21,692Qian Xiang et al.(2021)· European Journal of Clinical Pharmacology

A meta-analysis of 32 studies (21,692 individuals) examined SNPs associated with statin-induced myopathy (SIM). SLCO1B1 rs4149056 C allele significantly increased SIM risk in heterozygous (OR ~1.58), homozygous (OR ~4.47), dominant (OR ~1.89), and recessive (OR ~4.54) models. SLCO1B1 rs4363657 C allele was protective, and GATM rs9806699 A allele carriers had lower SIM risk with rosuvastatin treatment.

Traits studied:Elevated creatine kinaseMuscle injuryMuscle weaknessMyalgiaMyopathyRhabdomyolysisStatin-induced myopathy
Genetic factors involved in delayed methotrexate elimination in children with acute lymphoblastic leukemia
AssociationN=87Yu Cheng et al.(2021)· Pediatric Blood &amp; Cancer

This study examined genetic and epigenetic markers associated with chemotherapy-induced oral mucositis in 87 pediatric patients with hematological neoplasms, with 81.9% developing mucositis. Global DNA methylation was significantly reduced in children who recovered from mucositis (18% vs 40% in healthy controls, p<0.05), and the DNMT1 rs2228611 SNP showed association with global methylation levels in cancer patients with mucositis history. miR-9-1 and miR-9-3 methylation patterns were associated with tumor status rather than mucositis.

Traits studied:Acute lymphoblastic leukemiaChemotherapy-induced toxicityHematological neoplasmsOral mucositis
Interindividual Variability in the Hepatic Expression of the Human Breast Cancer Resistance Protein (BCRP/ABCG2): Effect of Age, Sex, and Genotype
AssociationN=1,000Bhagwat Prasad et al.(2013)· Journal of Pharmaceutical Sciences

Case-control study of 1,000 Han Chinese individuals (450 epilepsy cases, 550 controls) examining associations between STX1B polymorphisms and epilepsy treatment response. The rs140820592 variant showed significant association with reduced epilepsy risk (OR=0.542, p=0.004) and drug-resistant epilepsy risk (OR=0.260, p=0.004), with eQTL analysis confirming rs140820592 regulates STX1B expression in brain tissues.

Traits studied:Drug-resistant epilepsyDrug-responsive epilepsyEpilepsyImatinib response in chronic myelogenous leukemiaPraziquantel responseTacrolimus metabolism
A common and functional gene variant in the vascular endothelial growth factor a predicts clinical outcome in early‐stage breast cancer
ReviewGudrun Absenger et al.(2013)· Molecular Carcinogenesis

This document is a comprehensive collection of ~1,200 cancer-related research abstracts and summaries published in various journals (2013), covering clinical trials, pharmacogenomic studies, and mutation analyses across multiple cancer types including colorectal, breast, lung, lymphoma, and other malignancies. The collection documents associations between genetic variants (SNPs and somatic mutations), gene expression patterns, and cancer treatment outcomes, including studies on KRAS, EGFR, TP53, BRAF, and pharmacogenomic variants like CYP3A4 and UGT1A1.

Traits studied:Acute myeloid leukemiaBladder cancerBreast cancerChemotherapy responseChronic lymphocytic leukemiaColorectal cancerDisease-free survivalEsophageal cancerFollicular lymphomaGallbladder cancerGlioblastomaHead and neck cancerLymphomaMyelodysplastic syndromesNon-small cell lung cancer (NSCLC)Overall survivalPrimary mediastinal B-cell lymphomaProgression-free survivalProstate cancerRenal cell carcinoma
Sipa1 promoter polymorphism predicts risk and metastasis of lung cancer in Chinese
ReviewChenli Xie et al.(2013)· Molecular Carcinogenesis

This is a comprehensive journal compilation containing multiple oncology and pharmacogenomics studies published in 2013 across various journals. The collection includes 60+ papers covering cancer treatment outcomes, genetic polymorphisms predicting chemotherapy response and survival, pharmacogenetic variants in drug metabolism and DNA repair genes, and prognostic biomarkers in various cancer types including breast, lung, colorectal, hematologic malignancies, and others. Key findings include associations of XRCC1 variants (rs915927, rs76507, rs2854501, rs2854509, rs3213255) with bladder cancer chemotherapy survival, ABCG2 rs2725264 with lung cancer overall survival (HR 3.22), SLCO1B1 rs4149056 with methotrexate pharmacokinetics, MTHFR rs1801131 with acute lymphoblastic leukemia outcome, and ABCC3/GSTM variants with acute myeloid leukemia survival.

Traits studied:Acute lymphoblastic leukemiaAcute myeloid leukemiaBladder cancerBreast cancerChronic lymphocytic leukemiaChronic myeloid leukemiaChronic myelomonocytic leukemiaColorectal cancerFollicular lymphomaGastric cancerGastrointestinal stromal tumorsGlioblastomaHepatocellular carcinomaHodgkin lymphomaLung cancerMultiple myelomaMyelodysplastic syndromesMyxofibrosarcomasNon-small cell lung cancerPrimary mediastinal B-cell lymphomaProstate cancer
A Genome‐Wide Association Study for Serum Bilirubin Levels and Gene‐Environment Interaction in a Chinese Population
AssociationN=3,294Xiayun Dai et al.(2013)· Genetic Epidemiology

GWAS study of 3,294 European ancestry individuals from the eMERGE Network examining serum bilirubin and other liver function tests. Strong association signal at UGT1A1 locus (rs887829, beta=0.15, p=1.30×10^-118) confirmed in both adult and pediatric populations. Additional associations identified in SLCO1B1, SLCO1B3, TDRP, ZMYND8, and ABO locus. Phenome-wide analysis revealed protective effect of TA7 repeat against cerebrovascular disease (OR=0.75, p=0.0008).

Traits studied:ALTASTAlkaline phosphataseCerebrovascular diseaseGGTLiver function testsSerum bilirubin levels
SLCO1B1 haplotypes are not associated with atorvastatin-induced myalgia in Brazilian patients with familial hypercholesterolemia
AssociationN=143Paulo Caleb Junior Lima Santos et al.(2012)· European Journal of Clinical Pharmacology

A pharmacogenetic study of 143 Brazilian patients with familial hypercholesterolemia receiving atorvastatin examined whether SLCO1B1 haplotypes (rs2306283 and rs4149056) were associated with atorvastatin-induced myalgia. During 12-month follow-up, 14 patients (9.8%) developed myalgia and 16 (11.2%) had creatine kinase elevations >3× normal. No significant associations were found between SLCO1B1 genotypes or haplotypes and either myalgia (OR 2.08 for rs2306283 AG+GG, p=0.24; OR 2.24 for rs4149056 TC+CC, p=0.31) or elevated CK levels, suggesting the pharmacogenetic effect of SLCO1B1 variants is specific to simvastatin rather than atorvastatin.

Traits studied:Atorvastatin-induced myalgiaFamilial hypercholesterolemiaStatin-induced musculoskeletal side effects
Limited use of interleukin 28B in the setting of response-guided treatment with detailed on-treatment virological monitoring
ReviewAlessandra Mangia et al.(2011)· Hepatology

This is a special issue of the Italian medical journal BeAdfiles (September 2012) dedicated to genetic conditioning in HIV and hepatitis virus infections. It reviews the major genetic polymorphisms that influence disease progression, treatment response, and drug toxicity in HIV and chronic hepatitis B and C infections, with particular emphasis on IL28B polymorphisms (rs809917 and others) predicting HCV treatment response to interferon-alpha and ribavirin therapy, and ITPA gene variants protecting against ribavirin-induced anemia. The issue also covers pharmacogenetic markers (CYP2B6, ABCB1, HLA-B*5701) and their clinical applications in antiretroviral therapy.

Traits studied:AIDS progressionAntiretroviral therapy toxicityChronic hepatitis C sustained virological responseCreutzfeldt-Jakob diseaseDyslipidemiaEfavirenz side effectsHIV infection and progressionHepatitis B virus infectionHepatitis C genotype 1 response to interferonHepatitis C virus infectionHyperbilirubinemiaLeprosyLipodystrophyNeisseria meningitidis infectionNorovirus diarrheaPlasmodium falciparum malariaPlasmodium vivax malariaRenal impairmentRibavirin-induced anemiaTreatment response to interferon and ribavirinTuberculosis
Polymorphisms of the SLCO1B1 gene predict methotrexate‐related toxicity in childhood acute lymphoblastic leukemia
AssociationN=115Lopez-Lopez E. et al.(2011)· Pediatric Blood &amp; Cancer

This retrospective candidate gene study analyzed 115 Spanish pediatric B-ALL patients treated with high-dose methotrexate (MTX) under the standardized LAL/SHOP protocol. The study examined 10 polymorphisms in 7 genes (MTHFR, TS, SHMT1, RFC1, ABCB1, ABCG2, SLCO1B1) involved in MTX metabolism and their association with MTX toxicity using plasma MTX concentration as an objective marker. The key finding was a statistically significant association between the SLCO1B1 rs11045879 CC genotype and high MTX plasma concentrations (p=0.030 univariate, p=0.008 multivariate), with all patients carrying the CC genotype showing elevated MTX levels. The rs4149081 AA genotype in SLCO1B1 was also associated with high MTX plasma concentrations (p=0.097 univariate, p=0.057 multivariate). No significant associations were found with the other 8 polymorphisms in MTHFR, TS, SHMT1, RFC1, ABCB1, or ABCG2 genes.

Traits studied:DiarrheaHepatic toxicityHyperbilirubinemiaMethotrexate plasma concentrationMethotrexate-related toxicity in childhood acute lymphoblastic leukemiaMucositisRenal toxicityVomiting
Autoantibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase in patients with statin-associated autoimmune myopathy
Case reportN=750Andrew L. Mammen et al.(2011)· Arthritis &amp; Rheumatism

This study identified HMGCR (3-hydroxy-3-methylglutaryl-coenzyme A reductase) as a major autoantigen in statin-associated immune-mediated necrotizing myopathy (IMNM). Statins up-regulate HMGCR expression in cultured cells, and anti-HMGCR autoantibodies were found in 45 of 750 myopathy patients (6%), with 92% of those age 50+ having prior statin exposure. Notably, the prevalence of the rs4149056 C allele in anti-HMGCR positive patients (0.12) was not increased compared to the general population, indicating this SLCO1B1 SNP is not associated with statin-triggered autoimmune myopathy.

Traits studied:Immune-mediated necrotizing myopathy (IMNM)Statin-associated autoimmune myopathy
Frequency of the SLCO1B1 388A&gt;G and the 521T&gt;C polymorphism in Tanzania genotyped by a new LightCycler®-based method
AssociationN=602Eleni Aklillu et al.(2011)· European Journal of Clinical Pharmacology

This study established LightCycler 480-based genotyping methods for two SLCO1B1 polymorphisms (rs2306283 and rs4149056) and determined their frequencies in 366 Tanzanians and 236 Europeans. The rs2306283 (388A>G) polymorphism was much more prevalent in Tanzanians (87% vs 41% in Europeans), while rs4149056 (521T>C) was rare in Tanzanians (6% vs 17% in Europeans). The study found highly significant differences in allelic distribution between the populations (p<0.0001).

Traits studied:Pharmacogenetic variants (OATP1B1 transporter activity)
Association of polymorphisms in four bilirubin metabolism genes with serum bilirubin in three Asian populations
AssociationN=2,060Rong Lin et al.(2009)· Human Mutation

This association study investigated polymorphisms in four bilirubin metabolism genes (UGT1A1, HMOX1, BLVRA, SLCO1B1) with serum total bilirubin (TBIL) levels in three Asian populations (502 Kazak, 769 Uyghur, 789 Han). The UGT1A1 (TA)n repeat polymorphism and rs4148323:G>A were strongly associated with TBIL levels across all three populations (P<0.005), with the (TA)7 allele and A allele associated with higher TBIL levels. The (GT)n repeat polymorphism in HMOX1 showed association only in the Uyghur population. The (TA)n repeat and rs4148323 variants together explained 3.9-9.8% of TBIL variation by population.

Traits studied:HyperbilirubinemiaTotal serum bilirubin levels
Frequencies of single nucleotide polymorphisms and haplotypes of organic anion transporting polypeptide 1B1 SLCO1B1 gene in a Finnish population
AssociationN=468Marja K. Pasanen et al.(2006)· European Journal of Clinical Pharmacology

This study established high-throughput genotyping assays for major SNPs in the SLCO1B1 gene and determined their frequencies in 468 Finnish Caucasian subjects. The c.521T>C SNP (Val174Ala) had an allele frequency of 20.2%, and 26 haplotypes were identified, with the most common haplotype (c.571C) occurring at 35.6% frequency. The functionally significant c.521T>C variant existed in four major haplotypes (*16: 7.9%, *17: 6.9%, *5: 2.7%, *15: 2.4%), which are important for understanding OATP1B1-mediated drug pharmacokinetics and response.

Traits studied:Bilirubin levelsDrug pharmacokinetics and responseFexofenadine pharmacokineticsGilbert syndromePitavastatin plasma concentrationsPravastatin plasma concentrationsRepaglinide pharmacokineticsRosuvastatin plasma concentrations

Gene information from NCBI Gene. Variant classifications from ClinVar.

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