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Cleveland Clinic Study: Most Statin-Intolerant Patients Can Eventually Tolerate Statins

Authors recommend trying other drugs in the class (September 9)

Most patients who report statin intolerance, including muscle aches and other side effects from the cholesterol-lowering drugs, can actually tolerate drugs from this class on subsequent trials, according to research from the Cleveland Clinic released online and forthcoming in the September issue of the American Heart Journal.

In clinical trials, approximately 5% to 10% of patients report statin-related side effects, such as muscle pain and liver enzyme abnormalities, making them statin intolerant. In observational studies — which often incorporate patients not typically selected for clinical trials, including older patients, more women, and those with comorbidities — the rate of statin intolerance is as high as 20%.

In these patients, physicians often try intermittent dosing of statins to reduce side effects.

Researchers analyzed the electronic medical records of 1,605 patients who were referred to the Cleveland Clinic for statin intolerance between January 1995 and March 2010.

The investigators found that 72.5% of the patients who were previously reported to be intolerant to two or more statins were able to take drugs from that class on subsequent trials when they were overseen in the Cleveland Clinic’s preventative cardiology clinic and had their statin regimen carefully restarted. Further, 63.2% of previously statin-intolerant patients were able to tolerate a daily statin regimen, with only 9.3% receiving intermittent statin therapy. While the patients who remained on a daily dose of statin saw their cholesterol lowered to a greater extent than did those on intermittent statin dosing, the researchers found that the intermittent group did benefit significantly from the statin therapy.

“Our study shows that patients who have experienced statin intolerance should, under the close care of their physician, continue to try other drugs in this class because there is a very good chance that they will eventually be able to tolerate long-term use of a statin and to benefit from its cholesterol-lowering effects,” said lead investigator Leslie Cho, MD. “Even if patients cannot tolerate a daily dose of a statin, it’s possible to see a significant reduction in cholesterol levels from taking the drug less often, even as infrequently as once a week.”

Source: Cleveland Clinic; September 9, 2013.

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