Statins in Primary Biliary Cirrhosis: Are They Safe
Background and Aim Although cholesterol levels are elevated in patients with primary biliary cirrhosis (PBC), most PBC patients are not at increased risk of dying from atherosclerotic heart disease. There is, however, a subgroup, approximately 10%, who have additional disorders of lipid metabolism....
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| Veröffentlicht in: | Digestive diseases and sciences 2010-07, Vol.55 (7), p.2086-2088 |
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| description | Background and Aim Although cholesterol levels are elevated in patients with primary biliary cirrhosis (PBC), most PBC patients are not at increased risk of dying from atherosclerotic heart disease. There is, however, a subgroup, approximately 10%, who have additional disorders of lipid metabolism. They might benefit from a cholesterol-lowering agent. However, there is concern about using statins in patients with pre-existing liver disease. We therefore reviewed our experience with statins in a large cohort of PBC patients who were seen at Tufts Medical Center during the past decade. Methods From January 1, 1996, until June 30, 2006, 603 patients with PBC were seen by one of us (M.M.K.). Fifty-eight were on statins and five were on ezetimibe. The mean duration of usage was 41 months (range 3-125 months). Alanine aminotransferase (ALT) levels were measured at 3-month intervals. Results Statins were well tolerated. No patient complained of muscle pain or weakness. There was no increase in ALT levels. ALT levels were slightly elevated at the time that statins were begun (41.7 ± 25.1 U/l), and were normal at the last time these patients were seen (39.0 ± 21.0 U/l) (P ≤ 0.303). Serum cholesterol levels decreased by 30%, from 262 ± 45 mg/dl to 181 ± 14 mg/dl (P < 0.01). Ezetimibe was also well tolerated. Conclusion Statins are safe in PBC patients who might benefit from their use. |
| doi_str_mv | 10.1007/s10620-009-0988-9 |
| format | Article |
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There is, however, a subgroup, approximately 10%, who have additional disorders of lipid metabolism. They might benefit from a cholesterol-lowering agent. However, there is concern about using statins in patients with pre-existing liver disease. We therefore reviewed our experience with statins in a large cohort of PBC patients who were seen at Tufts Medical Center during the past decade. Methods From January 1, 1996, until June 30, 2006, 603 patients with PBC were seen by one of us (M.M.K.). Fifty-eight were on statins and five were on ezetimibe. The mean duration of usage was 41 months (range 3-125 months). Alanine aminotransferase (ALT) levels were measured at 3-month intervals. Results Statins were well tolerated. No patient complained of muscle pain or weakness. There was no increase in ALT levels. ALT levels were slightly elevated at the time that statins were begun (41.7 ± 25.1 U/l), and were normal at the last time these patients were seen (39.0 ± 21.0 U/l) (P ≤ 0.303). Serum cholesterol levels decreased by 30%, from 262 ± 45 mg/dl to 181 ± 14 mg/dl (P < 0.01). Ezetimibe was also well tolerated. Conclusion Statins are safe in PBC patients who might benefit from their use.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-009-0988-9</identifier><identifier>PMID: 19795210</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Boston: Boston : Springer US</publisher><subject>Aged ; Alanine Transaminase - blood ; Alanine Transaminase - drug effects ; Anticholesteremic Agents - adverse effects ; Anticholesteremic Agents - therapeutic use ; Azetidines - adverse effects ; Azetidines - therapeutic use ; Biliary cirrhosis ; Biochemistry ; Biological and medical sciences ; Cholesterol ; Cohort Studies ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug toxicity and drugs side effects treatment ; Drug-Related Side Effects and Adverse Reactions ; Ezetimibe ; Feeding. Feeding behavior ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Heart diseases ; Hepatology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Liver ; Liver - drug effects ; Liver Cirrhosis, Biliary - diagnosis ; Liver Cirrhosis, Biliary - drug therapy ; Liver Function Tests ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical centers ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Oncology ; Original Article ; Other diseases. Semiology ; Patient satisfaction ; Pharmacology. Drug treatments ; Physiological aspects ; Probability ; Retrospective Studies ; Risk Assessment ; Safety Management ; Severity of Illness Index ; Statins ; Toxicity: digestive system ; Transplant Surgery ; Treatment Outcome ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>Digestive diseases and sciences, 2010-07, Vol.55 (7), p.2086-2088</ispartof><rights>Springer Science+Business Media, LLC 2009</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Springer</rights><rights>Springer Science+Business Media, LLC 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-8e97bfd64619c4f9fdbfa4190ec9c7a909641a68a3acdec03fc09e5efbdf79433</citedby><cites>FETCH-LOGICAL-c491t-8e97bfd64619c4f9fdbfa4190ec9c7a909641a68a3acdec03fc09e5efbdf79433</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-009-0988-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-009-0988-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23014663$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19795210$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rajab, Murad Abu</creatorcontrib><creatorcontrib>Kaplan, Marshall M</creatorcontrib><title>Statins in Primary Biliary Cirrhosis: Are They Safe</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background and Aim Although cholesterol levels are elevated in patients with primary biliary cirrhosis (PBC), most PBC patients are not at increased risk of dying from atherosclerotic heart disease. There is, however, a subgroup, approximately 10%, who have additional disorders of lipid metabolism. They might benefit from a cholesterol-lowering agent. However, there is concern about using statins in patients with pre-existing liver disease. We therefore reviewed our experience with statins in a large cohort of PBC patients who were seen at Tufts Medical Center during the past decade. Methods From January 1, 1996, until June 30, 2006, 603 patients with PBC were seen by one of us (M.M.K.). Fifty-eight were on statins and five were on ezetimibe. The mean duration of usage was 41 months (range 3-125 months). Alanine aminotransferase (ALT) levels were measured at 3-month intervals. Results Statins were well tolerated. No patient complained of muscle pain or weakness. There was no increase in ALT levels. ALT levels were slightly elevated at the time that statins were begun (41.7 ± 25.1 U/l), and were normal at the last time these patients were seen (39.0 ± 21.0 U/l) (P ≤ 0.303). Serum cholesterol levels decreased by 30%, from 262 ± 45 mg/dl to 181 ± 14 mg/dl (P < 0.01). Ezetimibe was also well tolerated. Conclusion Statins are safe in PBC patients who might benefit from their use.</description><subject>Aged</subject><subject>Alanine Transaminase - blood</subject><subject>Alanine Transaminase - drug effects</subject><subject>Anticholesteremic Agents - adverse effects</subject><subject>Anticholesteremic Agents - therapeutic use</subject><subject>Azetidines - adverse effects</subject><subject>Azetidines - therapeutic use</subject><subject>Biliary cirrhosis</subject><subject>Biochemistry</subject><subject>Biological and medical sciences</subject><subject>Cholesterol</subject><subject>Cohort Studies</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Drug toxicity and drugs side effects treatment</subject><subject>Drug-Related Side Effects and Adverse Reactions</subject><subject>Ezetimibe</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Heart diseases</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Liver</subject><subject>Liver - drug effects</subject><subject>Liver Cirrhosis, Biliary - diagnosis</subject><subject>Liver Cirrhosis, Biliary - drug therapy</subject><subject>Liver Function Tests</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical centers</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Other diseases. Semiology</subject><subject>Patient satisfaction</subject><subject>Pharmacology. Drug treatments</subject><subject>Physiological aspects</subject><subject>Probability</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Safety Management</subject><subject>Severity of Illness Index</subject><subject>Statins</subject><subject>Toxicity: digestive system</subject><subject>Transplant Surgery</subject><subject>Treatment Outcome</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1LAzEQhoMoWqs_wIsuisfVmf3I7nirxS8QFKrnkGaTNtLuarI99N-bZYtFEMlhQvK8M8nD2AnCFQIU1x6BJxADUAxUljHtsAHmRRonOS932QCQhz0iP2CH3n9AAAvk--wAqaA8QRiwdNLK1tY-snX06uxSunV0axe2q2Pr3Lzx1t9EI6ejt7leRxNp9BHbM3Lh9fGmDtn7_d3b-DF-fnl4Go-eY5URtnGpqZiaimccSWWGTDU1MkMCrUgVkoB4hpKXMpWq0gpSo4B0rs20MgVlaTpk533fT9d8rbRvxUezcnUYKXJIMRA5D9BFD83kQgtbm6Z1Ui2tV2JUYEI5QICH7OoPKqxKL61qam1sOP8VwD6gXOO900Z89nYEgujki16-CE5FJ19QyJxu3ruaLnW1TWxsB-ByA0iv5MI4WSvrf7gkBcw47z6e9JwPV_VMu-3H_5t-1oeMbIScudD4fZIAhqZlzjuf32O2oiw</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Rajab, Murad Abu</creator><creator>Kaplan, Marshall M</creator><general>Boston : Springer US</general><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>FBQ</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20100701</creationdate><title>Statins in Primary Biliary Cirrhosis: Are They Safe</title><author>Rajab, Murad Abu ; Kaplan, Marshall M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-8e97bfd64619c4f9fdbfa4190ec9c7a909641a68a3acdec03fc09e5efbdf79433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Alanine Transaminase - blood</topic><topic>Alanine Transaminase - drug effects</topic><topic>Anticholesteremic Agents - adverse effects</topic><topic>Anticholesteremic Agents - therapeutic use</topic><topic>Azetidines - adverse effects</topic><topic>Azetidines - therapeutic use</topic><topic>Biliary cirrhosis</topic><topic>Biochemistry</topic><topic>Biological and medical sciences</topic><topic>Cholesterol</topic><topic>Cohort Studies</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Drug toxicity and drugs side effects treatment</topic><topic>Drug-Related Side Effects and Adverse Reactions</topic><topic>Ezetimibe</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Heart diseases</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Liver</topic><topic>Liver - drug effects</topic><topic>Liver Cirrhosis, Biliary - diagnosis</topic><topic>Liver Cirrhosis, Biliary - drug therapy</topic><topic>Liver Function Tests</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical centers</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Other diseases. Semiology</topic><topic>Patient satisfaction</topic><topic>Pharmacology. Drug treatments</topic><topic>Physiological aspects</topic><topic>Probability</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Safety Management</topic><topic>Severity of Illness Index</topic><topic>Statins</topic><topic>Toxicity: digestive system</topic><topic>Transplant Surgery</topic><topic>Treatment Outcome</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rajab, Murad Abu</creatorcontrib><creatorcontrib>Kaplan, Marshall M</creatorcontrib><collection>AGRIS</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rajab, Murad Abu</au><au>Kaplan, Marshall M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Statins in Primary Biliary Cirrhosis: Are They Safe</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>55</volume><issue>7</issue><spage>2086</spage><epage>2088</epage><pages>2086-2088</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>Background and Aim Although cholesterol levels are elevated in patients with primary biliary cirrhosis (PBC), most PBC patients are not at increased risk of dying from atherosclerotic heart disease. There is, however, a subgroup, approximately 10%, who have additional disorders of lipid metabolism. They might benefit from a cholesterol-lowering agent. However, there is concern about using statins in patients with pre-existing liver disease. We therefore reviewed our experience with statins in a large cohort of PBC patients who were seen at Tufts Medical Center during the past decade. Methods From January 1, 1996, until June 30, 2006, 603 patients with PBC were seen by one of us (M.M.K.). Fifty-eight were on statins and five were on ezetimibe. The mean duration of usage was 41 months (range 3-125 months). Alanine aminotransferase (ALT) levels were measured at 3-month intervals. Results Statins were well tolerated. No patient complained of muscle pain or weakness. There was no increase in ALT levels. ALT levels were slightly elevated at the time that statins were begun (41.7 ± 25.1 U/l), and were normal at the last time these patients were seen (39.0 ± 21.0 U/l) (P ≤ 0.303). Serum cholesterol levels decreased by 30%, from 262 ± 45 mg/dl to 181 ± 14 mg/dl (P < 0.01). Ezetimibe was also well tolerated. Conclusion Statins are safe in PBC patients who might benefit from their use.</abstract><cop>Boston</cop><pub>Boston : Springer US</pub><pmid>19795210</pmid><doi>10.1007/s10620-009-0988-9</doi><tpages>3</tpages></addata></record> |
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| subjects | Aged Alanine Transaminase - blood Alanine Transaminase - drug effects Anticholesteremic Agents - adverse effects Anticholesteremic Agents - therapeutic use Azetidines - adverse effects Azetidines - therapeutic use Biliary cirrhosis Biochemistry Biological and medical sciences Cholesterol Cohort Studies Dose-Response Relationship, Drug Drug Administration Schedule Drug toxicity and drugs side effects treatment Drug-Related Side Effects and Adverse Reactions Ezetimibe Feeding. Feeding behavior Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Heart diseases Hepatology Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Liver Liver - drug effects Liver Cirrhosis, Biliary - diagnosis Liver Cirrhosis, Biliary - drug therapy Liver Function Tests Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical centers Medical sciences Medicine Medicine & Public Health Middle Aged Oncology Original Article Other diseases. Semiology Patient satisfaction Pharmacology. Drug treatments Physiological aspects Probability Retrospective Studies Risk Assessment Safety Management Severity of Illness Index Statins Toxicity: digestive system Transplant Surgery Treatment Outcome Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| title | Statins in Primary Biliary Cirrhosis: Are They Safe |
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