Unmet Patient Need in Statin Intolerance: the Clinical Characteristics and Management

Academic Article

Abstract

  • Purpose: A substantial percentage of patients report intolerance or side effects of statin treatment leading to treatment changes or discontinuation. The purpose of this study was to examine statin therapy changes and subsequent effects on low-density lipoprotein cholesterol (LDL-C) among patients with statin intolerance (SI). Methods: We identified 45,037 adults from Kaiser Permanente Southern California with SI documented between 2006 and 2012. Changes in statin therapy in the year before and after the SI index date were examined. We categorized patients into those who initiated statin therapy, discontinued, up-titrated, down-titrated, or did not switch therapy. We calculated the percentage change in LDL-C from the year before to the year after SI, and the percentage of patients attaining LDL-C OpenSPiltSPi 100 and OpenSPiltSPi 70 mg/dL. Results: In the year prior to the SI date, 77.8% of patients filled a statin prescription. Following SI, 44.6% had no treatment change, 25.5% discontinued, and 30.0% altered their statin therapy. Of those who altered statin therapy, 52.6% down-titrated and 17.2% up-titrated their dose. Rhabdomyolysis was documented in OpenSPiltSPi 1% of the cohort. The largest changes in LDL-C were experienced by patients who were on a high-intensity statin then discontinued treatment (35.6% increase) and those who initiated a high-intensity statin (25.5% decrease). The proportion of patients achieving LDL-C OpenSPiltSPi 100 mg/dL and LDL-C OpenSPiltSPi 70 mg/dL was the lowest among those who discontinued therapy. Conclusions: Although adjustments to the statin dosage may be appropriate upon documentation of SI, many of these patients will have high LDL-C. Strategies for LDL-C reduction in patients with SI may be necessary.
  • Authors

    Published In

    Digital Object Identifier (doi)

    Pubmed Id

  • 7551316
  • Author List

  • Harrison TN; Hsu JWY; Rosenson RS; Levitan EB; Muntner P; Cheetham TC; Wei R; Scott RD; Reynolds K
  • Start Page

  • 29
  • End Page

  • 36
  • Volume

  • 32
  • Issue

  • 1