Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update
Abstract The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects...
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| Veröffentlicht in: | Canadian journal of cardiology 2013-12, Vol.29 (12), p.1553-1568 |
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| container_title | Canadian journal of cardiology |
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| creator | Mancini, G.B. John, MD Tashakkor, A. Yashar, MD Baker, Steven, MD Bergeron, Jean, MD Fitchett, David, MD Frohlich, Jiri, MD Genest, Jacques, MD Gupta, Milan, MD Hegele, Robert A., MD Ng, Dominic S., MD Pearson, Glen J., PharmD Pope, Janet, MD |
| description | Abstract The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time. |
| doi_str_mv | 10.1016/j.cjca.2013.09.023 |
| format | Article |
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John, MD ; Tashakkor, A. Yashar, MD ; Baker, Steven, MD ; Bergeron, Jean, MD ; Fitchett, David, MD ; Frohlich, Jiri, MD ; Genest, Jacques, MD ; Gupta, Milan, MD ; Hegele, Robert A., MD ; Ng, Dominic S., MD ; Pearson, Glen J., PharmD ; Pope, Janet, MD</creator><creatorcontrib>Mancini, G.B. John, MD ; Tashakkor, A. Yashar, MD ; Baker, Steven, MD ; Bergeron, Jean, MD ; Fitchett, David, MD ; Frohlich, Jiri, MD ; Genest, Jacques, MD ; Gupta, Milan, MD ; Hegele, Robert A., MD ; Ng, Dominic S., MD ; Pearson, Glen J., PharmD ; Pope, Janet, MD</creatorcontrib><description>Abstract The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time.</description><identifier>ISSN: 0828-282X</identifier><identifier>EISSN: 1916-7075</identifier><identifier>DOI: 10.1016/j.cjca.2013.09.023</identifier><identifier>PMID: 24267801</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Algorithms ; Cardiovascular ; Cardiovascular Diseases - prevention & control ; Contraindications ; Dose-Response Relationship, Drug ; Drug Interactions ; Evidence-Based Medicine ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Hyperlipidemias - drug therapy ; Muscular Diseases - chemically induced ; Muscular Diseases - diagnosis ; Muscular Diseases - prevention & control ; Patient Education as Topic ; Randomized Controlled Trials as Topic ; Risk Factors</subject><ispartof>Canadian journal of cardiology, 2013-12, Vol.29 (12), p.1553-1568</ispartof><rights>Canadian Cardiovascular Society</rights><rights>2013 Canadian Cardiovascular Society</rights><rights>Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-a08bd769809ad48e759ce4d64ebca793ab73eec0a8ebfb253e4fd6b83b8de3fa3</citedby><cites>FETCH-LOGICAL-c477t-a08bd769809ad48e759ce4d64ebca793ab73eec0a8ebfb253e4fd6b83b8de3fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0828282X13014712$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24267801$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mancini, G.B. John, MD</creatorcontrib><creatorcontrib>Tashakkor, A. Yashar, MD</creatorcontrib><creatorcontrib>Baker, Steven, MD</creatorcontrib><creatorcontrib>Bergeron, Jean, MD</creatorcontrib><creatorcontrib>Fitchett, David, MD</creatorcontrib><creatorcontrib>Frohlich, Jiri, MD</creatorcontrib><creatorcontrib>Genest, Jacques, MD</creatorcontrib><creatorcontrib>Gupta, Milan, MD</creatorcontrib><creatorcontrib>Hegele, Robert A., MD</creatorcontrib><creatorcontrib>Ng, Dominic S., MD</creatorcontrib><creatorcontrib>Pearson, Glen J., PharmD</creatorcontrib><creatorcontrib>Pope, Janet, MD</creatorcontrib><title>Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update</title><title>Canadian journal of cardiology</title><addtitle>Can J Cardiol</addtitle><description>Abstract The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time.</description><subject>Algorithms</subject><subject>Cardiovascular</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Contraindications</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Interactions</subject><subject>Evidence-Based Medicine</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</subject><subject>Hyperlipidemias - drug therapy</subject><subject>Muscular Diseases - chemically induced</subject><subject>Muscular Diseases - diagnosis</subject><subject>Muscular Diseases - prevention & control</subject><subject>Patient Education as Topic</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Risk Factors</subject><issn>0828-282X</issn><issn>1916-7075</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EokvhD3BAPnJogj-ysYNQpWrpl1QEUqngZjn2ZOU0ay92sqL_vk639NADp5FGz_tK8wxC7ykpKaH1p740vdElI5SXpCkJ4y_Qgja0LgQRy5doQSSTBZPs9wF6k1JPSEWFqF-jA1axWkhCF-jvV6fXPiSXjvCPCDvwowv-CGtv8Tft9Ro2eYVDh69HPTqPT-wOYgJ82nVgxvQAXvoxDBC1N_AZr3LKOu3xrxBvnV_j8ximLV4Fn8CnKeGbrdUjvEWvOj0kePc4D9HN2enP1UVx9f38cnVyVZhKiLHQRLZW1I0kjbaVBLFsDFS2rqA1WjRct4IDGKIltF3Llhyqztat5K20wDvND9HHfe82hj8TpFFtXDIwDNpDmJKiVU2lyGbqjLI9amJIKUKnttFtdLxTlKjZuOrVbFzNxhVpVDaeQx8e-6d2A_Yp8k9xBr7sAchX7hxElYyDrMq6mA0qG9z_-4-fxc3gvDN6uIU7SH2Yos_-FFWJKaKu55_PL6ec0EpQxu8BpKapBA</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Mancini, G.B. 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| identifier | ISSN: 0828-282X |
| ispartof | Canadian journal of cardiology, 2013-12, Vol.29 (12), p.1553-1568 |
| issn | 0828-282X 1916-7075 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Algorithms Cardiovascular Cardiovascular Diseases - prevention & control Contraindications Dose-Response Relationship, Drug Drug Interactions Evidence-Based Medicine Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Hyperlipidemias - drug therapy Muscular Diseases - chemically induced Muscular Diseases - diagnosis Muscular Diseases - prevention & control Patient Education as Topic Randomized Controlled Trials as Topic Risk Factors |
| title | Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update |
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