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Review
. 2018 Jun;18(3):157-173.
doi: 10.1007/s40256-017-0259-7.

Management of Statin Intolerance in 2018: Still More Questions Than Answers

Peter P Toth  1   2 , Angelo Maria Patti  3 , Rosaria Vincenza Giglio  3 , Dragana Nikolic  3 , Giuseppa Castellino  3 , Manfredi Rizzo  3 , Maciej Banach  4   5   6
Affiliations
Review

Management of Statin Intolerance in 2018: Still More Questions Than Answers

Peter P Toth et al. Am J Cardiovasc Drugs. 2018 Jun.

Abstract

Statin therapy is generally well tolerated and very effective in the prevention and treatment of cardiovascular disease, regardless of cholesterol levels; however, it can be associated with various adverse events (myalgia, myopathy, rhabdomyolysis, and diabetes mellitus, among others). Patients frequently discontinue statin therapy without medical advice because of perceived side effects and consequently increase their risk for cardiovascular events. In patients with statin intolerance, it may be advisable to change the dose, switch to a different statin, or try an alternate-day regimen. If intolerance is associated with all statins-even at the lowest dose-non-statin drugs and certain nutraceuticals can be considered. This review focuses on the definition of statin intolerance and on the development of clinical and therapeutic strategies for its management, including emerging alternative therapies.

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Conflict of interest statement

Funding

This review was written independently. The authors did not receive financial or professional help with the preparation of the manuscript.

Conflict of interest

Maciej Banach has no conflicts of interest that might be relevant to the contents of this manuscript. Peter P. Toth has previously received consulting fees and/or honoraria from AbbVie, Amarin, Amgen, Gemphire, Kowa, Merck, Regeneron, and Sanofi and payment for lectures from Amarin, Amgen, Kowa, Merck, Regeneron, and Sanofi. Rosaria Vincenza Giglio, Giuseppa Castellino, Angelo Maria Patti, and Dragana Nikolic have participated in clinical trials sponsored by AstraZeneca and Novo Nordisk. Manfredi Rizzo has given lectures, received honoraria and research support, and participated in conferences, advisory boards, and clinical trials sponsored by AstraZeneca, Boehringer Ingelheim, Kowa, Eli Lilly, Merck Sharp & Dohme, Novo Nordisk, Novartis, and Roche.

References

    1. Katsiki N, Mikhailidis DP, Banach M. Effects of statin treatment on endothelial function, oxidative stress and inflammation in patients with arterial hypertension and normal cholesterol levels. J Hypertens. 2011;29(12):2493–2494. - PubMed
    1. Raju SB, Varghese K, Madhu K. Management of statin intolerance. Indian J Endocrinol Metab. 2013;17:977–982. - PMC - PubMed
    1. Bosomworth NJ. Approach to identifying and managing atherogenic dyslipidemia: a metabolic consequence of obesity and diabetes. Can Fam Physician. 2013;59:1169–1180. - PMC - PubMed
    1. Banach M, Mikhailidis DP, Kjeldsen SE, et al. Time for new indications for statins? Med Sci Monit. 2009;15:MS1–MS5. - PubMed
    1. Ford ES, Ajani UA, Croft JB, et al. Explaining the decrease in U.S. deaths from coronary disease, 1980–2000. N Engl J Med. 2007;356:2388–2398. - PubMed

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