Factors Related to Adherence to Statin Therapy

McGinnis, Brandy; Olson, Kari L.; Magid, David J.; Bayliss, Elizabeth A.; Korner, Eli J.; Brand, David W.; Steiner, John F.

doi:10.1345/aph.1k209

Cited by 115 publications

(84 citation statements)

References 19 publications

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“…Discontinuations, and particularly long-term discontinuations, were more common among patients who had documented statin-related events, corroborating the findings of patient surveys (20)(21)(22). While the causative link between the statin-related event and discontinuation could not always be directly established, many discontinuations that did not have "Adverse reaction" declared as the reason could have been due to statin-related events.…”

Section: Discussionsupporting

confidence: 73%

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Discontinuation of Statins in Routine Care Settings

Zhang¹,

Plutzky²,

Turchin³

2013

Ann Intern Med

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Section: Discussionsupporting

confidence: 73%

“…Statin discontinuation has been linked to increased risk of cardiovascular events and death in patients with coronary artery disease (16)(17)(18)(19). Nevertheless the reasons why statins are stopped are only starting to be explored (20)(21)(22). Adverse reactions to statins feature prominently in these reports.…”

mentioning

confidence: 99%

Discontinuation of Statins in Routine Care Settings

Zhang¹,

Plutzky²,

Turchin³

2013

Ann Intern Med

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“…5 This lack of replication may be due to many confounding factors, but is likely related to the small population sizes frequently used. 6 Compliance is also an issue and poor response may be simply due to nonadherence 7 rather than by a biological process. In fact, if the number of noncompliers is larger than the number of true nonresponders, the signal would be difficult to detect at all.…”

mentioning

confidence: 99%

Comprehensive Whole-Genome and Candidate Gene Analysis for Response to Statin Therapy in the Treating to New Targets (TNT) Cohort

Thompson

Hyde

Wood

et al. 2009

Circ Cardiovasc Genet

174

132

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Background-Statins are effective at lowering low-density lipoprotein cholesterol and reducing risk of cardiovascular disease, but variability in response is not well understood. To address this, 5745 individuals from the Treating to New Targets (TNT) trial were genotyped in a combination of a whole-genome and candidate gene approach to identify associations with response to atorvastatin treatment. Methods and Results-A total of 291 988 single-nucleotide polymorphisms (SNPs) from 1984 individuals were analyzed for association with statin response, followed by genotyping top hits in 3761 additional individuals. None was significant at the whole-genome level in either the initial or follow-up test sets for association with low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triglyceride response. In addition to the whole-genome platform, 23 candidate genes previously associated with statin response were analyzed in these 5745 individuals. Three SNPs in apoE were most highly associated with low-density lipoprotein cholesterol response, followed by 1 in PCSK9 with a similar effect size. At the candidate gene level, SNPs in HMGCR were also significant though the effect was less than with those in apoE and PCSK9. rs7412/apoE had the most significant association (Pϭ6ϫ10

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“…In controlled clinical trials these have been quite rare occurrences [2], but recent cohort reports [5] and clinical experience suggest that these muscle and liver AEs associated with statin use are quite common with estimates ranging from 10% -20% [6]. The statin discontinuation rates are surprisingly high, about 30% within the first year of initiation of therapy [7][8][9][10]. One somewhat hitherto neglected and underestimated aspect is that the discontinuation of statins might increase the risk of adverse outcomes in acute coronary syndromes or stroke [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of Statin Treatment in Relation to Chronic Diseases and Laboratory Findings

Niskanen¹,

Suvisaari²,

Suvisaari³

et al. 2013

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Purpose: The aim was to study discontinuation of statin treatment, especially with respect to clinical characteristics and adverse effect measured by clinical laboratory tests indicating muscle damage (plasma creatine kinase, CK) and liver AEs (plasma alanine aminotransferase, ALAT). Methods: The initial study population included 60,488 individuals who had purchased first time statin prescription in Helsinki-Uusimaa region between 01-01-2007 and 31-12-2009. The follow-up started when first statin prescription was purchased and ended 31-12-2009 or death, which ever occurred first. From this population 54,172 individuals were defined to eligible to study population of this study. Clinical laboratory measurements were obtained from Helsinki-Uusimaa University Hospital (HUSLAB) that which provides the laboratory tests for the Helsinki-Uusimaa region serving about a population of 1.5 million. Results: In this fairly large real-life study the occurrence of ALAT-AE and mild CK-elevations after initiation of first statin treatments were relatively low. Increasing age and the presence of co-morbidities increased the risk of these AEs. Further, the ALAT-AEs implied increased risk of discontinuation of treatment. Diabetic patients discontinued treatment more often than nondiabetics, whereas the presence of other chronic conditions implied higher persistence of statin treatment. Conclusions: It is essential that those who would benefit from statin therapy actually are treated and by far in most patients treatment seems to be safe and well tolerated. For those who cannot tolerate statins new therapeutic options are needed.

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Factors Related to Adherence to Statin Therapy

Cited by 115 publications

References 19 publications

Discontinuation of Statins in Routine Care Settings

Discontinuation of Statins in Routine Care Settings

Comprehensive Whole-Genome and Candidate Gene Analysis for Response to Statin Therapy in the Treating to New Targets (TNT) Cohort

Discontinuation of Statin Treatment in Relation to Chronic Diseases and Laboratory Findings

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