Statin Discontinuation and Intolerance: The Challenge of Lifelong Therapy
Authors: Scott M. Grundy
Journal: Annals of Internal Medicine (2013)

Editorials2 April 2013Statin Discontinuation and Intolerance: The Challenge of Lifelong TherapyScott M. Grundy, MD, PhDScott M. Grundy, MD, PhDFrom Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-7-201304020-00010 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Statins are among the most widely prescribed drugs. They reduce atherosclerotic cardiovascular disease events and improve survival in patients with established disease. Recommendations virtually mandate statin use in secondary prevention and widely advocate use for primary prevention. Clinicians initiate statin therapy with the expectation that the patient will continue lifelong treatment. However, this is a tall order for many persons, and it is not surprising that discontinuation rates are relatively high (1–3). As reported in this issue, Zhang and colleagues (4) explored the frequency of discontinuing statins in 1 hospital system. Combining data from structured electronic medical records and electronic ...References1. Ellis JJ, Erickson SR, Stevenson JG, Bernstein SJ, Stiles RA, Fendrick AM. Suboptimal statin adherence and discontinuation in primary and secondary prevention populations. J Gen Intern Med. 2004;19:638-45. [PMID: 15209602] CrossrefMedlineGoogle Scholar2. Chodick G, Shalev V, Gerber Y, Heymann AD, Silber H, Simah V, et al. Long-term persistence with statin treatment in a not-for-profit health maintenance organization: a population-based retrospective cohort study in Israel. Clin Ther. 2008;30:2167-79. [PMID: 19108805] CrossrefMedlineGoogle Scholar3. Degli Esposti L, Saragoni S, Batacchi P, Benemei S, Geppetti P, Sturani A, et al. Adherence to statin treatment and health outcomes in an Italian cohort of newly treated patients: results from an administrative database analysis. Clin Ther. 2012;34:190-9. [PMID: 22284998] CrossrefMedlineGoogle Scholar4. Zhang H, Plutzky J, Skentzos S, Morrison F, Mar P, Shubina M, et al. Discontinuation of statins in routine care settings. A cohort study. Ann Intern Med. 2013;158:526-34. LinkGoogle Scholar5. Lemstra M, Blackburn D, Crawley A, Fung R. Proportion and risk indicators of nonadherence to statin therapy: a meta-analysis. Can J Cardiol. 2012;28:574-80. [PMID: 22884278] CrossrefMedlineGoogle Scholar6. Pittman DG, Fenton C, Chen W, Haffner S, Pendergrass M. Relation of statin nonadherence and treatment intensification. Am J Cardiol. 2012;110:1459-63. [PMID: 22877424] CrossrefMedlineGoogle Scholar7. Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012;125:882-7. [PMID: 22748400] CrossrefMedlineGoogle Scholar8. Jung K, McBean AM, Kim JA. Comparison of statin adherence among beneficiaries in MA-PD plans versus PDPs. J Manag Care Pharm. 2012;18:106-15. [PMID: 22380470] CrossrefMedlineGoogle Scholar9. Deambrosis P, Saramin C, Terrazzani G, Scaldaferri L, Debetto P, Giusti P, et al. Evaluation of the prescription and utilization patterns of statins in an Italian local health unit during the period 1994-2003. Eur J Clin Pharmacol. 2007;63:197-203. [PMID: 17200832] CrossrefMedlineGoogle Scholar10. Mancini GB, Baker S, Bergeron J, Fitchett D, Frohlich J, Genest J, et al. Diagnosis, prevention, and management of statin adverse effects and intolerance: proceedings of a Canadian Working Group Consensus Conference. Can J Cardiol. 2011;27:635-62. [PMID: 21963058] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Scott M. Grundy, MD, PhDAffiliations: From Center for Human Nutrition, University of Texas Southwestern Medical Center, Dallas, Texas.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-0413.Corresponding Author: Scott M. Grundy, MD, PhD, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Suite Y3.206, Dallas, TX 75390-9052; e-mail, scott.[email protected].edu. 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LeBlanc, MD, MA, Jean S. Kutner, MD, MSPH, Christine S. Ritchie, MD, MSPH, and Amy P. Abernethy, MDMost patients can tolerate statins long termMost patients can tolerate statins long term 2 April 2013Volume 158, Issue 7Page: 562-563KeywordsAdverse reactionsAtherosclerotic cardiovascular diseaseClinical trialsDiabetes preventionDrug adherenceDrugsElectronic medical recordsMusclesMyalgiaStatins ePublished: 2 April 2013 Issue Published: 2 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...