Potential statin drug interactions in elderly patients: a review

Damiani, Isabella; Corsini, Alberto; Bellosta, Stefano

doi:10.1080/17425255.2020.1822324

Cited by 22 publications

(10 citation statements)

References 109 publications

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“…The overall low prevalence of statin use in our population was not dissimilar to that reported in the worldwide adult population aged 40+. 21 Despite their undisputed efficacy in the prevention and treatment of cardiovascular diseases, the poor use could be explained by the intolerance mainly associated with muscle symptoms and related adverse events. 23 Moreover, new LLDs, such as bempedoic acid, a non-statin drug that targets cholesterol biosynthesis and provides promising results both alone or in combination with statins, 21 might have offered a valid alternative in these patients, especially in those enrolled in the last runs of the REPOSI register.…”

Section: Discussionmentioning

confidence: 99%

Use of Lipid-Lowering Drugs and Associated Outcomes According to Health State Profiles in Hospitalized Older Patients

Franchi

Lancellotti

Bertolotti

et al. 2021

CIA

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Objective To assess how lipid-lowering drugs (LLDs) are administered in the hospitalized patients aged 65 and older and their association with clinical outcomes according to their health-related profiles. Design This is a retrospective study based on data from REPOSI (REgistro POliterapie SIMI – Italian Society of Internal Medicine) register, an Italian network of internal medicine hospital wards. Setting and Participants A total of 4642 patients with a mean age of 79 years enrolled between 2010 and 2018. Methods Socio-demographic characteristics, functional abilities, cognitive skills, laboratory parameters and comorbidities were used to investigate the health state profiles by using multiple correspondence analysis and clustering. Logistic regression was used to assess whether LLD prescription was associated with patients’ health state profiles and with short-term mortality. Results Four clusters of patients were identified according to their health state: two of them (Cluster III and IV) were the epitome of frailty conditions with poor short-term outcomes, whereas the others included healthier patients. The average prevalence of LLD use was 27.6%. The lowest prevalence was found among the healthier patients in Cluster I and among the oldest frail patients with severe functional and cognitive impairment in Cluster IV. The highest prevalence was among multimorbid patients in Cluster III (OR=4.50, 95% CI=3.76–5.38) characterized by a high cardiovascular risk. Being prescribed with LLDs was associated with a lower 3-month mortality, even after adjusting for cluster assignment (OR=0.59; 95% CI = 0.44–0.80). Conclusion The prevalence of LLD prescription was low and in overall agreement with guideline recommendations and with respect to patients’ health state profiles.

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Section: Discussionmentioning

confidence: 99%

Use of Lipid-Lowering Drugs and Associated Outcomes According to Health State Profiles in Hospitalized Older Patients

Franchi

Lancellotti

Bertolotti

et al. 2021

CIA

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“…Although generally statins are well tolerated, their use may be associated with rhabdomyolysis and related kidney injury, as well as liver toxicity, which may compound COVID-19 systemic disease [40,41]. Since most statins are substrates of the hepatic cytochrome P450 system, co-administration of statins with protease inhibitor-based antiretroviral agents or certain immunosuppressive drugs may markedly increase the risks of adverse effects in patients with COVID-19 due to drug interactions [34,42]. Despite these considerations, continuation of statin therapy is recommended in patients with newly diagnosed COVID-19 infection due to their proven beneficial effects on cardiovascular outcomes in appropriate clinical settings [34].…”

Section: Plos Onementioning

confidence: 99%

Statins use and COVID-19 outcomes in hospitalized patients

et al. 2021

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Background There is an urgent need for novel therapeutic strategies for reversing COVID-19-related lung inflammation. Recent evidence has demonstrated that the cholesterol-lowering agents, statins, are associated with reduced mortality in patients with various respiratory infections. We sought to investigate the relationship between statin use and COVID-19 disease severity in hospitalized patients. Methods A retrospective analysis of COVID-19 patients admitted to the Johns Hopkins Medical Institutions between March 1, 2020 and June 30, 2020 was performed. The outcomes of interest were mortality and severe COVID-19 infection, as defined by prolonged hospital stay (≥ 7 days) and/ or invasive mechanical ventilation. Logistic regression, Cox proportional hazards regression and propensity score matching were used to obtain both univariable and multivariable associations between covariates and outcomes in addition to the average treatment effect of statin use. Results Of the 4,447 patients who met our inclusion criteria, 594 (13.4%) patients were exposed to statins on admission, of which 340 (57.2%) were male. The mean age was higher in statin users compared to non-users [64.9 ± 13.4 vs. 45.5 ± 16.6 years, p <0.001]. The average treatment effect of statin use on COVID-19-related mortality was RR = 1.00 (95% CI: 0.99–1.01, p = 0.928), while its effect on severe COVID-19 infection was RR = 1.18 (95% CI: 1.11–1.27, p <0.001). Conclusion Statin use was not associated with altered mortality, but with an 18% increased risk of severe COVID-19 infection.

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“…Rhabdomyolysis is a life-threatening disease that begins with myalgia and progresses to myocyte necrosis, hyperkalemia, and the release of myoglobin into the bloodstream, which can damage the kidneys in a variety of ways, including mechanical obstruction of tubules due to precipitation in the glomerular filtrate, direct renal toxic effect of myoglobin, and hypovolemia [ 9 ].…”

Section: Discussionmentioning

confidence: 99%