18 Mar 2023 • Statin intolerance is prevalent in about 9% of patients receiving statin treatment, according to a relatively recent meta-analysis that included information from 176 cohort studies, clinical trials, and case series involving more than 4 million patients. Female sex (47.9%), obesity (30.6%), hypothyroidism (37.6%), diabetes (26.6%), use of antiarrhythmics (31.2%), alcohol use (22%), physical activity (23.2%), chronic liver disease (24.3%), chronic kidney failure (25.2%), use of calcium channel blockers (35.5%), and use of high-dose statins (37.5%) were among the risk factors for statin intolerance that were identified by the study. Statin intolerance is described as "the inability to tolerate at least two statins at the lowest permitted doses due to musculoskeletal symptoms" by the US Food and Drug Administration (FDA). López-Jiménez, MD, a cardiologist from the Mayo Clinic's Department of Cardiology talked about some practical guidelines for the diagnosis of statin intolerance which are measuring the enzyme creatine phosphokinase and evaluating the level of certainty that relates the symptoms to statins by means of causality rules. The evaluation of risk perceptions is an additional critical component. López-Jiménez added "If we inform the patient that the likelihood of a serious event, death, hospitalisation, or serious problems while taking statins is less than 1 in 3 million people, they may leave fearing the unlikely event rather than concentrating on the risk of the event itself. Thus, emphasise that the risk of not taking a statin is significantly higher, particularly for people with cardiovascular disease."

Source: Medscape | Read full story