Treating statin-intolerant patients

Marcello Arca, Giovanni PignaAtherosclerosis Unit, Department of Internal Medicine and Allied Medical Specialities, Sapienza University of Rome, Rome, ItalyAbstract: Statins are effective in reducing cardiovascular events and are safe for almost all patients. Nevertheless, intolerance to statins is...

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Autores principales:	Pigna G, Arca M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/5e535c38cd7c4df99c762956cf2b16d0
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spelling	oai:doaj.org-article:5e535c38cd7c4df99c762956cf2b16d02021-12-02T08:33:29ZTreating statin-intolerant patients1178-7007https://doaj.org/article/5e535c38cd7c4df99c762956cf2b16d02011-04-01T00:00:00Zhttp://www.dovepress.com/treating-statin-intolerant-patients-a7251https://doaj.org/toc/1178-7007Marcello Arca, Giovanni PignaAtherosclerosis Unit, Department of Internal Medicine and Allied Medical Specialities, Sapienza University of Rome, Rome, ItalyAbstract: Statins are effective in reducing cardiovascular events and are safe for almost all patients. Nevertheless, intolerance to statins is frequently faced in clinical practice. This is mostly due to muscular symptoms (myalgia with or without increase of plasma creatinine kinase) and/or elevation of hepatic aminotransferases, which overall constitutes approximately two-thirds of reported adverse events during statin therapy. These side effects raise concerns in patients as well as in doctors and are likely to reduce patients&#39; adherence and, as a consequence, the cardiovascular benefit. Therefore, it is mandatory that clinicians improve their knowledge on the clinical aspects of muscular and hepatic side effects of statin therapy as well as their ability to manage patients with statin intolerance. Besides briefly examining the clinical aspects and the mechanisms that are proposed to be responsible for the most common statin-associated side effects, the main purpose of this article is to review the available approaches to manage statin-intolerant patients. The first step is to determine whether the adverse events are indeed related to statin therapy. If so, lowering the dosage or changing statin, alternate dosing options, or the use of nonstatin compounds may be practical strategies. The cholesterol-lowering potency as well as the usefulness of these different approaches in treating statin-intolerant patients will be examined based on currently available data. However, the cardiovascular benefit of these strategies has not been well established, so their use has to be guided by a careful clinical assessment of each patient.Keywords: statin therapy, atorvastatin, rosuvastatin, aminotransferase levels, myopathyPigna GArca MDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2011, Iss default, Pp 155-166 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Pigna G Arca M Treating statin-intolerant patients
description	Marcello Arca, Giovanni PignaAtherosclerosis Unit, Department of Internal Medicine and Allied Medical Specialities, Sapienza University of Rome, Rome, ItalyAbstract: Statins are effective in reducing cardiovascular events and are safe for almost all patients. Nevertheless, intolerance to statins is frequently faced in clinical practice. This is mostly due to muscular symptoms (myalgia with or without increase of plasma creatinine kinase) and/or elevation of hepatic aminotransferases, which overall constitutes approximately two-thirds of reported adverse events during statin therapy. These side effects raise concerns in patients as well as in doctors and are likely to reduce patients&#39; adherence and, as a consequence, the cardiovascular benefit. Therefore, it is mandatory that clinicians improve their knowledge on the clinical aspects of muscular and hepatic side effects of statin therapy as well as their ability to manage patients with statin intolerance. Besides briefly examining the clinical aspects and the mechanisms that are proposed to be responsible for the most common statin-associated side effects, the main purpose of this article is to review the available approaches to manage statin-intolerant patients. The first step is to determine whether the adverse events are indeed related to statin therapy. If so, lowering the dosage or changing statin, alternate dosing options, or the use of nonstatin compounds may be practical strategies. The cholesterol-lowering potency as well as the usefulness of these different approaches in treating statin-intolerant patients will be examined based on currently available data. However, the cardiovascular benefit of these strategies has not been well established, so their use has to be guided by a careful clinical assessment of each patient.Keywords: statin therapy, atorvastatin, rosuvastatin, aminotransferase levels, myopathy
format	article
author	Pigna G Arca M
author_facet	Pigna G Arca M
author_sort	Pigna G
title	Treating statin-intolerant patients
title_short	Treating statin-intolerant patients
title_full	Treating statin-intolerant patients
title_fullStr	Treating statin-intolerant patients
title_full_unstemmed	Treating statin-intolerant patients
title_sort	treating statin-intolerant patients
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/5e535c38cd7c4df99c762956cf2b16d0
work_keys_str_mv	AT pignag treatingstatinintolerantpatients AT arcam treatingstatinintolerantpatients
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Treating statin-intolerant patients

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