Identification and Management of Statin-Associated Symptoms in Clinical Practice: Extension of a Clinician Survey to 12 Further Countries

Abstract

PurposeStatins are the first-choice pharmacological treatment for patients with hypercholesterolemia and at risk for cardiovascular disease; however, a minority of patients experience statin-associated symptoms (SAS) and are considered to have reduced statin tolerance. The objective of this study was to establish how patients with SAS are identified and managed in clinical practice in Austria, Belgium, Colombia, Croatia, the Czech Republic, Denmark, Portugal, Switzerland, Russia, Saudi Arabia, Turkey, and the United Arab Emirates.MethodsA cross-sectional survey was conducted (2015–2016) among clinicians (n = 60 per country; Croatia: n = 30) who are specialized/experienced in the treatment of hypercholesterolemia. Participants were asked about their experience of patients presenting with potential SAS and how such patients were identified and treated.ResultsMuscle-related symptoms were the most common presentation of potential SAS (average: 51%; range across countries [RAC] 17–74%); other signs/symptoms included persistent elevation in transaminases. To establish whether symptoms are due to statins, clinicians required rechallenge after discontinuation of statin treatment (average: 77%; RAC 40–90%); other requirements included trying at least one alternative statin. Clinicians reported that half of high-risk patients with confirmed SAS receive a lower-dose statin (average: 53%; RAC 43–72%), and that most receive another non-statin lipid-lowering therapy with or without a concomitant statin (average: 65%; RAC 52–83%).ConclusionsThe specialists and GPs surveyed use stringent criteria to establish causality between statin use and signs or symptoms, and persevere with statin treatment where possible.Electronic supplementary materialThe online version of this article (doi:10.1007/s10557-017-6727-0) contains supplementary material, which is available to authorized users.

Statin associated adverse reactions in Latin America: a scoping review

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Zebrafish as a Model for the Study of Lipid-Lowering Drug-Induced Myopathies

“…However, muscle-related side effects of statin treatment are frequently reported. Interestingly, one of the rare statin-associated side effects is immune-mediated necrotizing myopathy (IMNM) [ 55 ], reviewed by [ 56 ]. IMNM is diagnosed by the presence of muscle fibres necrosis and degeneration, and is correlated with CK level and muscle strength [ 56 , 57 ].…”

Mechanism of Action of Shenerjiangzhi Formulation on Hyperlipidemia Induced by Consumption of a High-Fat Diet in Rats Using Network Pharmacology and Analyses of the Gut Microbiota

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