Management of dyslipidaemia in statin-intolerant patients in light of AHA and NPA guidelines of 2013–2014

Statin-induced musculoskeletal effects account for about two-thirds of all adverse events and are the most common cause for the drug discontinuation. In view of its proven benefit for cardiovascular risk reduction, statins are the most important medications that should not be stopped until absolutely contraindicated. This concept is also endorsed by the recent AHA and NLA recommendations. Various strategies like lowering the daily dose, non-daily dosing, switching therapy, non-statin lipid-lowering drugs, Co-enzyme Q and dietary interventions have been tried with inconsistent results. Newly introduced molecules such as Mipomersen, Evolocumab and Alirocumab may show some promise in management of the statin-intolerant patients in future.