An excellent new study offers noteworthy findings for primary care clinicians.
The study, published in the American Heart Journal, shows that intermittent statin dosing can be an effective treatment option in some patients who have previously been intolerant of statins. This approach to treatment can reduce LDL-C levels and help patients achieve LDL-C goals.1
Mampuya and colleagues conducted a retrospective analysis of over 15 years of records of 1605 patients referred to the Cleveland Clinic Preventive Cardiology Section for statin intolerance who were followed for at least 6 months. Most (72.5%) patients with prior statin intolerance were able to tolerate a statin drug for a median follow-up of 31 months.
Reductions in LDL-C levels were significantly lower among the 149 patients receiving intermittent statin dosing than in 1014 patients taking a daily dose (21.3 % vs 27.7%, respectively; P < .04). Relative to the 442 who discontinued statins, however, the 149 had a significantly greater LDL-C reduction (21% vs 8.3 %; P < .001); a significantly higher portion of the group of 149 also achieved the Adult Treatment Panel III goal for LDL-C (61% vs 44%; P < .05).
Among those receiving daily and intermittent statin dosing, there was a trend toward a decrease in all-cause mortality at 8 years (P = .08).
The authors concluded that most patients who demonstrated prior statin intolerance are able to tolerate a subsequent trial. Intermittent dosing of a statin can be an effective treatment option in these patients.
1. Mampuya WM, Frid D, Rocco M, et al. Treatment strategies in patients with statin intolerance: The Cleveland Clinic experience. Am Heart J. 2013;166:597-603.