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Statin Intolerance in Clinical Practice

  • Statin Drugs (R. Ceska, Section Editor)
  • Published:
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Abstract

Purpose of Review

In our pilot study, we aimed to determine how many patients with the statin intolerance history referred to the specialized center for the diagnostics and treatment of lipoprotein metabolism disorders really suffer from a complete statin intolerance. The purpose of the study was to prove that complete statin intolerance is overestimated and overdiagnosed, and with the detailed knowledge of the issue and patient approach, it is possible to find an appropriate statin treatment for the most of patients.

Recent Findings

With the increasing number of statin users worldwide, the issue of statin intolerance has been a frequently discussed topic in recent years. There are many factors that play a role in the manifestation of statin intolerance (predisposing factors as age, sex, and some diseases), genetic factors leading to a different metabolism, drug-drug interactions, psychological reasons, and the negative influence of the mass media. However, it is estimated that true complete statin intolerance, defined by an intolerance of at least three statins at their usual lowest daily doses, occurs in approximately 3–6% of all statin users.

Summary

In our pilot study, we conducted a retrospective analysis of 300 patients who were referred to the Center of Preventive Cardiology with a history of statin intolerance. During the follow-up treatment, 222 patients (74%) were able to use some statin (rosu-, atorva-, simva-, fluvastatin), and in 21% of the cases (63 patient), the target values according their CV risk level were even achieved. Only 78 patients (26%) were confirmed as being complete statin intolerant following a thorough therapeutic effort. The most tolerated statin was rosuvastatin.

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Funding

This article was supported by Ministry of Health, Czech Republic—conceptual development of research organization 64165, General University Hospital in Prague, Czech Republic.

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Authors and Affiliations

  1. Center of Preventive Cardiology, 3rd Department of Internal Medicine, General University Hospital, 1st Faculty of Medicine, Charles University Prague, U nemocnice 1, 128 00, Praha, Czech Republic

    Michaela Snejdrlova, T. Altschmiedova, M. Vrablik, T. Stulc & R. Ceska

  2. Internal Department, Masaryk Hospital, Usti nad Labem, Czech Republic

    J. Lastuvka

  3. Department of Statistics, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

    V. Lanska

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  1. Michaela Snejdrlova
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Corresponding author

Correspondence to Michaela Snejdrlova.

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Conflict of Interest

Dr. Snejdrlova reports grants from Ministry of Health, Czech Republic—conceptual development of research organization 64,165, General University Hospital in Prague—during the conduct of the study; personal fees from Amgen, personal fees and non-financial support from Sanofi, personal fees and non-financial support from Servier, and personal fees and non-financial support from Mylan, outside the submitted work.

Dr. Altschmiedova reports grants from Ministry of Health, Czech Republic—conceptual development of research organization 64,165, General University Hospital in Prague, Czech Republic—during the conduct of the study.

Dr. Vrablik reports grants from Ministry of Health, Czech Republic—conceptual development of research organization 64,165, General University Hospital in Prague—during the conduct of the study; grants and personal fees from Pfizer, grants, personal fees, and non-financial support from Sanofi; grants, personal fees, and non-financial support from Amgen; and personal fees from MSD, outside the submitted work .

Dr. Stulc reports grants from Ministry of Health, Czech Republic—conceptual development of research organization 64,165, General University Hospital in Prague—during the conduct of the study.

Dr. Lastuvka has nothing to disclose.

Dr. Lanska has nothing to disclose.

Dr. Ceska reports grants from Ministry of Health, Czech Republic—conceptual development of research organization 64,165, General University Hospital in Prague, Czech Republic—during the conduct of the study; grants and personal fees from Pfizer, personal fees and non-financial support from Amgen, personal fees from Mylan, personal fees and non-financial support from Herbacos Recordati, and personal fees from Roche, outside the submitted work .

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Snejdrlova, M., Altschmiedova, T., Vrablik, M. et al. Statin Intolerance in Clinical Practice. Curr Atheroscler Rep 22, 27 (2020). https://doi.org/10.1007/s11883-020-00845-9

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