The Risk of Hepatotoxicity, New Onset Diabetes and Rhabdomyolysis in the Era of High-Intensity Statin Therapy: Does Statin Type Matter?

Benes, Lane B.; Bassi, Nikhil; Davidson, Michael

doi:10.1016/j.pcad.2016.08.001

Cited by 26 publications

(31 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our patient also developed diabetes while using statin. Although statin therapy has been linked to a possible increased risk of developing new onset diabetes, 13 any causal relationship in this particular case is impossible to determine.…”

Section: Discussionmentioning

confidence: 99%

Recurrence and Severe Worsening of Hepatotoxicity After Reintroduction of Atorvastatin in Combination With Ezetimibe

Ellingsen

Nordmo

Lappegård

2017

Clin Med Insights Case Rep

View full text Add to dashboard Cite

Severe hepatotoxicity is a rare but well-known adverse reaction to statins. However, despite the widespread use of statins, only a few cases describing statin reexposure or switch to another statin after liver injury have been published. The literature on hepatotoxicity with ezetimibe alone or in combination with statins is also scarce. We report a case where a patient with a history of elevated liver enzymes while using atorvastatin, but prior and subsequent good tolerance to simvastatin and pravastatin, developed drug-induced liver injury on reexposure to a combination of atorvastatin and ezetimibe. The hepatotoxicity in our patient was most likely caused by reexposure to atorvastatin, although we cannot exclude ezetimibe as a contributing factor. This case highlights the risk of hepatotoxicity recurrence on rechallenge with the same statin. The tolerance to other statins in this case also strengthens the suspicion that statin-induced liver injury may not be a class effect, although the current data are too scarce to draw any definite conclusions.

show abstract

Section: Discussionmentioning

confidence: 99%

Recurrence and Severe Worsening of Hepatotoxicity After Reintroduction of Atorvastatin in Combination With Ezetimibe

Ellingsen

Nordmo

Lappegård

2017

Clin Med Insights Case Rep

View full text Add to dashboard Cite

show abstract

“…Atorvastatin also interacts with CYP3A4 but to a lesser degree [ 4 ]. Rosuvastatin, in contrast, is metabolized predominantly through CYP2C9 [ 5 ]. Because current guidelines recommend high-intensity statin therapy for both primary and secondary prevention of atherosclerotic cardiovascular disease, side effects such as rhabdomyolysis are seen more commonly.…”

Section: Discussionmentioning

confidence: 99%

“…Because current guidelines recommend high-intensity statin therapy for both primary and secondary prevention of atherosclerotic cardiovascular disease, side effects such as rhabdomyolysis are seen more commonly. The most important consideration to reduce such side effects is to limit concomitant use of CYP3A4 inhibitors or inducers [ 5 ]. In the case reported here, statin-induced rhabdomyolysis occurred with concomitant pazopanib and rosuvastatin use, despite the fact that rosuvastatin is predominantly metabolized by CYP2C9.…”

Section: Discussionmentioning

confidence: 99%

Pazopanib and Statin-Induced Rhabdomyolysis

2017

View full text Add to dashboard Cite

Background: The VEGF inhibitor pazopanib is a widely used first-line therapy for the treatment of advanced renal cell carcinoma. Potential drug-drug interactions and toxicities may be underrecognized. Case Presentation: A 73-year-old woman with metastatic renal cell carcinoma on treatment with pazopanib presented with progressive inability to ambulate. The initial concern was for metastasis to the spine. However, MRI of the spine revealed diffuse muscle edema with no metastatic deposits or lytic lesions. Upon further evaluation, creatine kinase was significantly elevated and the diagnosis of rhabdomyolysis was made. With aggressive hydration and discontinuation of both pazopanib and rosuvastatin, the patient made a full recovery. Conclusion: This case of drug-induced rhabdomyolysis demonstrates an unexpected toxicity resulting from concomitant pazopanib and rosuvastatin therapy. This combination is predicted to be safe due to different, nonoverlapping effects on the cytochrome p450 enzymes. Discontinuation of statin therapy in patients with metastatic cancer should be considered when the risk of cancer-related death exceeds the risk of cardiovascular-related death.

show abstract

“…It is noteworthy that, the pharmacokinetic properties of different statins vary significantly (Benes et al, 2016 ). Most of the statins are mainly metabolized in the liver by cytochrome P450 enzymes, with the exception of pravastatin, rosuvastatin, fluvastatin, and pitavastatin [National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III), 2002 ; Benes et al, 2016 ], which should be preferred with concomitant use of CYP3A4 inhibitors (Benes et al, 2016 ).…”

Section: Management Of Fhmentioning

confidence: 99%

Familial Hypercholesterolemia: New Horizons for Diagnosis and Effective Management

et al. 2018

View full text Add to dashboard Cite

Familial hypercholesterolemia (FH) is a common genetic cause of premature cardiovascular disease (CVD). The reported prevalence rates for both heterozygous FH (HeFH) and homozygous FH (HoFH) vary significantly, and this can be attributed, at least in part, to the variable diagnostic criteria used across different populations. Due to lack of consistent data, new global registries and unified guidelines are being formed, which are expected to advance current knowledge and improve the care of FH patients. This review presents a comprehensive overview of the pathophysiology, epidemiology, manifestations, and pharmacological treatment of FH, whilst summarizing the up-to-date relevant recommendations and guidelines. Ongoing research in FH seems promising and novel therapies are expected to be introduced in clinical practice in order to compliment or even substitute current treatment options, aiming for better lipid-lowering effects, fewer side effects, and improved clinical outcomes.

show abstract

The Risk of Hepatotoxicity, New Onset Diabetes and Rhabdomyolysis in the Era of High-Intensity Statin Therapy: Does Statin Type Matter?

Cited by 26 publications

References 64 publications

Recurrence and Severe Worsening of Hepatotoxicity After Reintroduction of Atorvastatin in Combination With Ezetimibe

Recurrence and Severe Worsening of Hepatotoxicity After Reintroduction of Atorvastatin in Combination With Ezetimibe

Pazopanib and Statin-Induced Rhabdomyolysis

Familial Hypercholesterolemia: New Horizons for Diagnosis and Effective Management

Contact Info

Product

Resources

About