CETP and ABCA1 genotype together determine whether atorvastatin or simvastatin gives a better lipid response (Angiology 2012)

Original title: Cholesteryl ester transfer protein and ATP-binding cassette transporter A1 genotype alter the atorvastatin and simvastatin efficacy: time for genotype-guided therapy?

Angiology · 13 May 2012 · 7

Kolovou G, Kolovou V, Mihas C, Giannakopoulou V, Vasiliadis I, Boussoula E, Kollia A, Boutsikou M, Katsiki N, Mavrogeni S

Comparing lipid response to atorvastatin (n=254) versus simvastatin (n=332) across CETP (TaqIB and I405V) and ABCA1 (R219K) genotypes, researchers found genotype-specific efficacy differences between the two statins. In B1B2 carriers, atorvastatin produced a greater total cholesterol reduction (35.4% versus 31.6%, P=.035) but a smaller HDL-C increase (2% versus 8%, P=.05) than simvastatin. In B2B2 carriers, atorvastatin produced a smaller LDL-C reduction than simvastatin (31.85% versus 42%, P=.029). In both RR and KK ABCA1 genotypes, atorvastatin produced a greater triglyceride reduction than simvastatin (27% versus 17% and 35% versus 15% respectively, P=.02 for all comparisons), suggesting CETP TaqIB and ABCA1 R219K genotypes could guide the choice between these two statins.

Original abstract

We compared the efficacy of atorvastatin with simvastatin according to cholesteryl ester transfer protein (CETP) and adenosine triphosphate-binding cassette transporter A1 (ABCA1) genes. Patients treated with atorvastatin (n = 254) or simvastatin (n = 332) were genotyped for CETP (TaqIB and I405V) and ABCA1 (R219K) genetic variants. For genotype B1B2, atorvastatin compared with simvastatin treatment resulted in a greater decrease in total cholesterol (35.4% vs 31.6%, P = .035) and a lower increase in high-density lipoprotein cholesterol (2% vs 8%, P = .05). For genotype B2B2, atorvastatin compared with simvastatin treatment resulted in a lower decrease in low-density lipoprotein cholesterol (31.85 vs 42%, P = .029). For genotypes RR and KK, atorvastatin compared with simvastatin treatment resulted in a greater decrease of triglycerides (27% vs 17% and 35% vs 15%, respectively; P = .02 for all comparisons). The TaqIB and R219K (opposite to I405V) gene polymorphisms seem to modify the response to lipid-lowering therapy with simvastatin or atorvastatin treatment.

Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.