Most Patients With Adverse Reaction To Statins, Can Ultimately Tolerate Them

MedicalResearch.com Interview with:

Alexander Turchin, M.D., M.S. FACMI Associate Professor of Medicine ENDOCRINOLOGY, DIABETES AND HYPERTENSION BRIGHAM AND WOMEN'S HOSPITAL

Dr. Turchin

Alexander Turchin, M.D., M.S. FACMI
Associate Professor of Medicine
ENDOCRINOLOGY, DIABETES AND HYPERTENSION
BRIGHAM AND WOMEN’S HOSPITAL

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Statins are known to reduce the risk of cardiovascular events and death, and are some of the most commonly prescribed medications. However, many patients stop taking statins, most commonly because of adverse reactions. It has been shown previously that many individuals who discontinued statin therapy after an adverse reaction are ultimately able to tolerate statins, and that reattempting statin therapy after an adverse reaction is associated with reduced risk of cardiovascular events and death. However, optimal patient selection criteria and methods of reattempting treatment with statins are unknown. We therefore conducted this study to identify patient and treatment characteristics associated with an increased chances of successful reattempt of statin therapy after an adverse reaction.

Through analysis of EMR data of over 6,000 patients we found that the following were associated with higher chances of successful statin therapy reattempt:

  • Reattempted treatment with a different statin
  • Patient at high cardiovascular risk (prior history of CAD, stroke or diabetes)

On the other hand, the following were associated with lower chances of success:

  • Adverse reaction was reported in the first year after starting statin therapy
  • Adverse reaction was myalgia or myopathy
  • Previous history of adverse reactions to other (non-statin) medications 

 MedicalResearch.com: What should readers take away from your report?

 Response: Our study again showed that majority (nearly three quarters in our population) of patients who had symptoms thought to be due to an adverse reaction to a statin can ultimately tolerate statin therapy, and most should consider trying statins again. While no single factor was strong enough to preclude a reattempt of statin therapy after an adverse reaction, patients who have multiple characteristics associated with lack of successful reattempt (e.g. muscle pain that started soon after the statin was initiated, in absence of CAD, stroke or diabetes) may consider deferring statin therapy or trying an alternative (e.g. ezetimibe).

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: These findings were based on a retrospective, “real-world” study. They should be confirmed by a prospective, controlled investigation.

Disclosures: My disclosures relevant to this study include research funding from Sanofi-Aventis. 

Citations:

Predictors of a Successful Statin Reattempt after an Adverse Reaction
Journal of Clinical Lipidology
Available online 14 February 2018
Huabing Zhang MD Jorge KlutzkyMD
 WendongGePhDMariaShubinaScD,AlexanderTurchinMD, MS

ENDO 2018
 Predictors of a Successful Statin Reattempt after an Adverse Reaction
Huabing Zhang, MD1, Jorge Plutzky, MD2, Wendong Ge, PhD3, Maria Shubina, ScD3, Alexander Turchin, MD, MS
1Peking Union Medical College Hospital, Beijing, China, 2Harvard Medical School, Boston, MA, USA, 3Brigham and Women’s Hospital, Boston, MA, USA, 4Brigham and Women’s Hosp, Boston, MA, USA. 

 

 

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