Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5619643 | Progress in Cardiovascular Diseases | 2016 | 39 Pages |
Abstract
Statin intolerance is a commonly encountered clinical problem for which useful management strategies exist. Although many patients report statin-related muscle symptoms, studies indicate that the majority of these patients can tolerate a statin upon re-challenge. Alternative statin dosing strategies are an effective way to modify and reintroduce statin therapy for patients reporting adverse symptoms. Correction of vitamin D deficiency and hypothyroidism may improve statin tolerability in some patients. CoQ10 supplementation has been found to be of no benefit for statin-related muscle symptoms in most recent clinical trials. PCSK9 inhibitors are a new therapeutic option that if confirmed as safe and effective by outcomes trials may be of substantial benefit to select patients at high ASCVD risk who are unable to achieve adequate low-density lipoprotein cholesterol (LDL-C) lowering on maximally tolerated statin therapy. Other available medications to lower LDL-C in statin intolerant patients include ezetimibe, bile acid sequestrants, niacin, and fibrates.
Keywords
LDL-CASCVDFDAHMG-CoARCTT2DMULNPCSK9CoQ103-hydroxy-3-methylglutaryl coenzyme AACC/AHARandomized controlled trialFederal Drug AdministrationNational Lipid AssociationAtherosclerotic cardiovascular diseaseUpper limit of normalType 2 diabetes mellitusStatin intolerancePCSK9 inhibitorsmyalgiasMyopathyNlaProprotein convertase subtilisin/kexin type 9American College of Cardiology/American Heart AssociationCreatine kinaseLow-density lipoprotein cholesterol
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Authors
David R. Saxon, Robert H. Eckel,