Tags

Type your tag names separated by a space and hit enter

Overcoming toxicity and side-effects of lipid-lowering therapies.
Best Pract Res Clin Endocrinol Metab. 2014 Jun; 28(3):439-52.BP

Abstract

Lowering serum lipid levels is part of the foundation of treating and preventing clinically significant cardiovascular disease. Recently, the American Heart Association/American College of Cardiology released cholesterol guidelines which advocate for high efficacy statins rather than LDL-c goals for five patient subgroups at high risk for cardiovascular disease. Therefore, it is critical that clinicians have an approach for managing side-effects of statin therapy. Statins are associated with myopathy, transaminase elevations, and an increased risk of incident diabetes mellitus among some patients; connections between statins and other processes, such as renal and neurologic function, have also been studied with mixed results. Statin-related adverse effects might be minimized by careful assessment of patient risk factors. Strategies to continue statin therapy despite adverse effects include switching to another statin at a lower dose and titrating up, giving intermittent doses of statins, and adding non-statin agents. Non-statin lipid-lowering drugs have their own unique limitations. Management strategies and algorithms for statin-associated toxicities are available to help guide clinicians. Clinical practice should emphasize tailoring therapy to address each individual's cholesterol goals and risk of developing adverse effects on lipid-lowering drugs.

Authors+Show Affiliations

University of Chicago, Department of Medicine, Chicago, IL, USA. Electronic address: michael.wilkinson@uchospitals.edu.University of Chicago, Department of Medicine, Chicago, IL, USA. Electronic address: luke.laffin@uchospitals.edu.University of Chicago, Department of Medicine, Chicago, IL, USA. Electronic address: mdavidso@bsd.uchicago.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24840269

Citation

Wilkinson, Michael J., et al. "Overcoming Toxicity and Side-effects of Lipid-lowering Therapies." Best Practice & Research. Clinical Endocrinology & Metabolism, vol. 28, no. 3, 2014, pp. 439-52.
Wilkinson MJ, Laffin LJ, Davidson MH. Overcoming toxicity and side-effects of lipid-lowering therapies. Best Pract Res Clin Endocrinol Metab. 2014;28(3):439-52.
Wilkinson, M. J., Laffin, L. J., & Davidson, M. H. (2014). Overcoming toxicity and side-effects of lipid-lowering therapies. Best Practice & Research. Clinical Endocrinology & Metabolism, 28(3), 439-52. https://doi.org/10.1016/j.beem.2014.01.006
Wilkinson MJ, Laffin LJ, Davidson MH. Overcoming Toxicity and Side-effects of Lipid-lowering Therapies. Best Pract Res Clin Endocrinol Metab. 2014;28(3):439-52. PubMed PMID: 24840269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overcoming toxicity and side-effects of lipid-lowering therapies. AU - Wilkinson,Michael J, AU - Laffin,Luke J, AU - Davidson,Michael H, Y1 - 2014/01/23/ PY - 2014/5/21/entrez PY - 2014/5/21/pubmed PY - 2015/1/13/medline KW - atherosclerosis KW - cardiovascular diseases KW - drug toxicity KW - hydroxymethylglutaryl-CoA reductase inhibitors KW - hypercholesterolemia KW - lipoproteins SP - 439 EP - 52 JF - Best practice & research. Clinical endocrinology & metabolism JO - Best Pract. Res. Clin. Endocrinol. Metab. VL - 28 IS - 3 N2 - Lowering serum lipid levels is part of the foundation of treating and preventing clinically significant cardiovascular disease. Recently, the American Heart Association/American College of Cardiology released cholesterol guidelines which advocate for high efficacy statins rather than LDL-c goals for five patient subgroups at high risk for cardiovascular disease. Therefore, it is critical that clinicians have an approach for managing side-effects of statin therapy. Statins are associated with myopathy, transaminase elevations, and an increased risk of incident diabetes mellitus among some patients; connections between statins and other processes, such as renal and neurologic function, have also been studied with mixed results. Statin-related adverse effects might be minimized by careful assessment of patient risk factors. Strategies to continue statin therapy despite adverse effects include switching to another statin at a lower dose and titrating up, giving intermittent doses of statins, and adding non-statin agents. Non-statin lipid-lowering drugs have their own unique limitations. Management strategies and algorithms for statin-associated toxicities are available to help guide clinicians. Clinical practice should emphasize tailoring therapy to address each individual's cholesterol goals and risk of developing adverse effects on lipid-lowering drugs. SN - 1878-1594 UR - https://www.unboundmedicine.com/medline/citation/24840269/Overcoming_toxicity_and_side_effects_of_lipid_lowering_therapies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1521-690X(14)00022-0 DB - PRIME DP - Unbound Medicine ER -