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Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update.
Can J Cardiol. 2013 Dec; 29(12):1553-68.CJ

Abstract

The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time.

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: mancini@mail.ubc.ca.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Consensus Development Conference
Journal Article
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24267801

Citation

Mancini, G B John, et al. "Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update." The Canadian Journal of Cardiology, vol. 29, no. 12, 2013, pp. 1553-68.
Mancini GB, Tashakkor AY, Baker S, et al. Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update. Can J Cardiol. 2013;29(12):1553-68.
Mancini, G. B., Tashakkor, A. Y., Baker, S., Bergeron, J., Fitchett, D., Frohlich, J., Genest, J., Gupta, M., Hegele, R. A., Ng, D. S., Pearson, G. J., & Pope, J. (2013). Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update. The Canadian Journal of Cardiology, 29(12), 1553-68. https://doi.org/10.1016/j.cjca.2013.09.023
Mancini GB, et al. Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update. Can J Cardiol. 2013;29(12):1553-68. PubMed PMID: 24267801.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update. AU - Mancini,G B John, AU - Tashakkor,A Yashar, AU - Baker,Steven, AU - Bergeron,Jean, AU - Fitchett,David, AU - Frohlich,Jiri, AU - Genest,Jacques, AU - Gupta,Milan, AU - Hegele,Robert A, AU - Ng,Dominic S, AU - Pearson,Glen J, AU - Pope,Janet, Y1 - 2013/09/29/ PY - 2013/09/18/received PY - 2013/09/24/revised PY - 2013/09/24/accepted PY - 2013/11/26/entrez PY - 2013/11/26/pubmed PY - 2014/1/22/medline SP - 1553 EP - 68 JF - The Canadian journal of cardiology JO - Can J Cardiol VL - 29 IS - 12 N2 - The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time. SN - 1916-7075 UR - https://www.unboundmedicine.com/medline/citation/24267801/Diagnosis_prevention_and_management_of_statin_adverse_effects_and_intolerance:_Canadian_Working_Group_Consensus_update_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0828-282X(13)01471-2 DB - PRIME DP - Unbound Medicine ER -