Article

Effectiveness and tolerability of every-other-day rosuvastatin dosing in patients with prior statin intolerance.

Department of Pharmacy Practice, Schools of Pharmacy and Medicine, University of KansasKansas City, KS 66160, USA.
Annals of Pharmacotherapy (impact factor: 2.13). 04/2008; 42(3):341-6. DOI:10.1345/aph.1K604 pp.341-6
Source: PubMed

ABSTRACT Statins are generally well tolerated, but some patients discontinue therapy secondary to adverse effects. Dosing a statin (rosuvastatin) every other day (EOD) may provide significant lipoprotein changes while avoiding common adverse effects in this statin-intolerant population.
To determine the effect and tolerance of EOD rosuvastatin in patients previously intolerant to statin therapy.
We performed a retrospective analysis of patients treated with EOD rosuvastatin at 2 lipid specialty clinics: the University of Kansas Lipid, Atherosclerosis, and LDL-Apheresis Center and the Hartford Hospital Cholesterol Management Center. Approximately 2600 charts were reviewed to identify patients receiving rosuvastatin EOD who previously had experienced statin intolerance. Fifty-one patients were eligible for the analysis, which evaluated changes in the lipid profile, the number achieving their low-density lipoprotein cholesterol (LDL-C) goals, and the percent tolerating rosuvastatin EOD. Laboratory data were assessed immediately prior to rosuvastatin EOD therapy and at the first follow-up.
Myalgias (76.5%) and increased transaminase levels (19.5%) were the most common causes of prior statin intolerance, but 72.5% (37/51) of patients were able to tolerate the EOD therapy (mean dose 5.6 mg) regimen for 4 +/- 2.9 (mean +/- SD) months. Mean LDL-C decreased 34.5% (p < 0.001) in the patients who tolerated the regimen, enabling approximately 50% to achieve their LDL-C goal. All patients who were considered to be intolerant to rosuvastatin EOD therapy (27.5%; 14/51) re-experienced the symptoms of their prior statin intolerance.
Treating patients intolerant to statins with rosuvastatin EOD was tolerated by the majority of patients and reduced LDL-C in our study. This dosing strategy may be useful in patients intolerant to once-daily statin dosing, although such an approach has not been documented to reduce cardiovascular events.

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Keywords

2 lipid specialty clinics
 
adverse effects
 
common adverse effects
 
evaluated changes
 
Hartford Hospital Cholesterol Management Center
 
Laboratory data
 
low-density lipoprotein cholesterol
 
Mean LDL-C
 
once-daily statin dosing
 
patients intolerant
 
percent tolerating rosuvastatin EOD
 
prior statin intolerance
 
retrospective analysis
 
rosuvastatin EOD therapy
 
significant lipoprotein changes
 
statin intolerance
 
statin-intolerant population
 
therapy secondary
 
transaminase levels
 
Treating patients intolerant