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Statin intolerance.
Curr Opin Lipidol. 2015 Dec; 26(6):492-501.CO

Abstract

PURPOSE OF REVIEW

Adherence to hydroxymethylglutaryl-CoA reductase reductase inhibitor (statin) therapy correlates with cardiovascular mortality. Muscle symptoms are the most significant side-effects of statin therapy. This review article summarizes the current concepts of the diagnosis and clinical work-up of patients with statin-associated muscle symptoms (SAMS).

RECENT FINDINGS

SAMS represent a major barrier to maintain long-term persistence to statin treatment. SAMS reduce the quality of life and rare complications may extend to rhabdomyolysis. The molecular pathology of SAMS is heterogeneous. After exclusion of other causes of muscle symptoms the main principle of treatment is re-exposure to very low dose of statin and slow uptitration until the maximally tolerated dose is established. Using this approach the vast majority of patients can be treated with statins long term. For patients with SAMS that are not at low-density lipoproteins (LDL) goal with their maximally tolerated dose of statin combination therapy with ezetimibe and proprotein convertase subtilisin/kexin-9 inhibitors are available.

SUMMARY

Time and care is needed to address SAMS because they impair drug adherence. For most patients it is possible to continue the statin therapy. However, combination therapy is wanted if the maximally tolerated statin dose is not sufficient to reach LDL targets.

Authors+Show Affiliations

aKlinik Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, GermanybClinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, AustriacMedical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, HeidelbergdSynlab Academy, Synlab Services GmbH, Mannheim and Augsburg, Germany.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26780003

Citation

Laufs, Ulrich, et al. "Statin Intolerance." Current Opinion in Lipidology, vol. 26, no. 6, 2015, pp. 492-501.
Laufs U, Scharnagl H, März W. Statin intolerance. Curr Opin Lipidol. 2015;26(6):492-501.
Laufs, U., Scharnagl, H., & März, W. (2015). Statin intolerance. Current Opinion in Lipidology, 26(6), 492-501. https://doi.org/10.1097/MOL.0000000000000236
Laufs U, Scharnagl H, März W. Statin Intolerance. Curr Opin Lipidol. 2015;26(6):492-501. PubMed PMID: 26780003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin intolerance. AU - Laufs,Ulrich, AU - Scharnagl,Hubert, AU - März,Winfried, PY - 2016/1/19/entrez PY - 2016/1/19/pubmed PY - 2016/10/13/medline SP - 492 EP - 501 JF - Current opinion in lipidology JO - Curr. Opin. Lipidol. VL - 26 IS - 6 N2 - PURPOSE OF REVIEW: Adherence to hydroxymethylglutaryl-CoA reductase reductase inhibitor (statin) therapy correlates with cardiovascular mortality. Muscle symptoms are the most significant side-effects of statin therapy. This review article summarizes the current concepts of the diagnosis and clinical work-up of patients with statin-associated muscle symptoms (SAMS). RECENT FINDINGS: SAMS represent a major barrier to maintain long-term persistence to statin treatment. SAMS reduce the quality of life and rare complications may extend to rhabdomyolysis. The molecular pathology of SAMS is heterogeneous. After exclusion of other causes of muscle symptoms the main principle of treatment is re-exposure to very low dose of statin and slow uptitration until the maximally tolerated dose is established. Using this approach the vast majority of patients can be treated with statins long term. For patients with SAMS that are not at low-density lipoproteins (LDL) goal with their maximally tolerated dose of statin combination therapy with ezetimibe and proprotein convertase subtilisin/kexin-9 inhibitors are available. SUMMARY: Time and care is needed to address SAMS because they impair drug adherence. For most patients it is possible to continue the statin therapy. However, combination therapy is wanted if the maximally tolerated statin dose is not sufficient to reach LDL targets. SN - 1473-6535 UR - https://www.unboundmedicine.com/medline/citation/26780003/Statin_intolerance_ L2 - http://dx.doi.org/10.1097/MOL.0000000000000236 DB - PRIME DP - Unbound Medicine ER -