Continuation of Statin Treatment and All-Cause Mortality

Shalev, Varda; Chodick, Gabriel; Silber, Haim; Kokia, Ehud; Jan, Joseph; Heymann, Anthony

doi:10.1001/archinternmed.2008.552

Cited by 139 publications

(101 citation statements)

References 33 publications

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“…Over 40% of patients have discontinued their lipid-lowering treatment within first 6 months, and up to 50% within their first year [9][10][11]. On the other hand, the adherence to statins has been proven to significantly reduce cardiovascular morbidity, and mortality in both primary, and secondary prevention [10,12,13]. Unfortunately, a number of interventions tested so far had little impact on patients' adherence to the treatment for hyperlipidemia [14].…”

Section: Introductionmentioning

confidence: 99%

An education-behavioural intervention improves adherence to statins

Kardas

2013

Open Medicine

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Section: Introductionmentioning

confidence: 99%

An education-behavioural intervention improves adherence to statins

Kardas

2013

Open Medicine

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“…Statins have been shown to reduce the risk of cardiovascular events in a wide variety of high-risk patients [1][2]; however, benefits of statin therapy may be compromised because of suboptimal persistence with and adherence to it [3][4][5]. One quarter to 50% of new statin users discontinue the therapy during the first year [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, no consensus exists on the required time period without statin use before the first observed use. In administrative database studies, periods without any statin (or any lipid-lowering drug [4]) dispensations prior to the cohort entry have ranged from 3−6 months [17][18] to 1−3 years [3][4][5][19][20]. The choice of this so called washout period is likely to be motivated by the reimbursement, prescribing and dispensing rules of the healthcare system through which the data for a specific study are generated.…”

Section: Introductionmentioning

confidence: 99%

Dynamics of long-term statin therapy

Korhonen

Helin‐Salmivaara

Huupponen

2011

Eur J Clin Pharmacol

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(250 words)Purpose Knowledge of different usage patterns emerging during a long-term statin therapy is limited.We aimed at characterizing statin use, including rates of reinitiation after extended periods of non-use, transitions between good and poor adherence, and the effect of the length of a drug-free period on identification of new use. by the end of follow-up. Of those followed-up for 10 years or longer, 51.8% accumulated 6 or more years of treatment with good adherence. In 2007, 27.7% of the initiators having no statin purchases within the previous year had refills during the preceding 10 years. MethodsConclusion Statin use is dynamic. This should be taken into consideration in clinical practice and when studying the incidence, patterns and health outcomes of statin use.

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“…A patient's ability to attain LDL-C targets can arise from pharmacogenomic factors, such as genetic variations in organic anion-transporting polypeptide (OATP) transporters [Couvert et al 2008;Igel et al 2006;Thompson et al 2005], LDL receptors [Polisecki et al 2008], multidrug resistance (MDR)1 transporter [Mega et al 2009], apolipoprotein E (apoE) [Mega et al 2009], breast cancer resistance protein (BCRP) [Bailey et al 2010] and 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase [Chasman, 2004]. However, more common reasons include failure to attain LDL-C targets, which has largely been attributed to underdosing/failure to uptitrate dosages where necessary and poor compliance/persistence with treatment [Shalev et al 2009;Meade, 2007]. Although these factors could be improved by better physician/patient education and more frequent follow-up visits, increasing demands on physician's time and insufficient funding mean this is not always possible.…”

Section: Introductionmentioning

confidence: 99%

Pitavastatin: finding its place in therapy

Ose

2011

Therapeutic Advances in Chronic Disease

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Dyslipidaemia is a major risk factor for cardiovascular (CV) disease. Despite the widespread availability of effective lipid-lowering agents, an unacceptably large proportion of patients fail to attain their target low-density lipoprotein cholesterol (LDL-C) level in clinical practice. Reasons for this include undertreatment, poor adherence/persistence with therapy and failure to address non-LDL-C residual risk factors such as high levels of triglycerides, low high-density lipoprotein cholesterol (HDL-C) concentrations and raised apolipoprotein B : apolipoprotein A1 ratios. Pitavastatin is a novel, well-tolerated statin with a noninferior or superior lipid-lowering efficacy to comparable doses of atorvastatin, simvastatin, and pravastatin in a wide range of patients with hypercholesterolemia or combined dyslipidaemia. Compared with other statins, pitavastatin produces consistently greater increases in HDL-C levels that are sustained over the long term. In addition to pitavastatin's potent effects on lipid profiles, a number of pleiotropic benefits have been identified that may contribute to a reduction in residual cardiovascular risk in people with dyslipidaemia and could partly account for pitavastatin's ability to regress coronary plaques in patients with acute coronary syndrome. Pitavastatin's unique metabolic profile results in a high efficacy at low (14 mg) doses and minimal drug interactions with cytochrome CYP3A4 substrates, making it an excellent choice for people requiring multiple medications. Although future trials are required to assess the impact of pitavastatin treatment on CV morbidity and mortality, studies to date suggest that pitavastatin will play an important role in the future management of dyslipidaemia and in the overall reduction of CV risk.

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Continuation of Statin Treatment and All-Cause Mortality

Abstract: Better continuity of statin treatment provided an ongoing reduction in mortality among patients with and without a known history of CHD. The observed benefits from statins were greater than expected from randomized clinical trials.

Cited by 139 publications

References 33 publications

An education-behavioural intervention improves adherence to statins

An education-behavioural intervention improves adherence to statins

Dynamics of long-term statin therapy

Pitavastatin: finding its place in therapy

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