Up to 15 percent of patients who take cholesterol-lowering statin medications experience muscle pain or other side effects, and many patients simply stop taking the drugs.
But a Loyola University Medical Center study has found that “statin-intolerant” patients still can significantly reduce their cholesterol by going to a lipid clinic staffed with physicians specially trained in treating cholesterol problems.
Among 22 statin-intolerant patients referred to Loyola’s Lipid Clinic, total cholesterol dropped from 257 mg/dl to 198 mg/dl. LDL (“bad”) cholesterol dropped from 172 mg/dl to 123 mg/dl, the study found.
By comparison, in a control group of 21 statin-intolerant patients who were not referred to a lipid clinic, total cholesterol dropped by only 3 points, and LDL cholesterol dropped by only 1 point.
“Stain intolerance can be a significant barrier to patients in meeting their cholesterol goals,” said Binh An P. Phan, MD, senior author of the study. “Referring to a formal lipid clinic may be an effective strategy to help improve cholesterol treatment in this challenging population.”
Findings were presented at the 2013 National Lipid Association Scientific Sessions by Taishi Hirai, MD, a co-author of the study.
Side Effects Prompt Patients To Stop Cholesterol Drugs
With one-quarter of adults over age 45 taking cholesterol-lowering statin drugs, it figures that more than a few people would have trouble sticking with the program.
More than a few, actually.
A big new study of statin use in the real world found that 17 percent of patients taking the pills reported side effects, including muscle pain, nausea, and problems with their liver or nervous system.
That’s a lot higher than the 5 to 10 percent reported in the randomized controlled trials that provided evidence for regulatory approval of the medicines.
This , which was published in Annals of Internal Medicine, looked at more than 100,000 people who’d been prescribed statins from 2000 through 2008 at two academic medical centers.
About two-thirds of people with side effects quit taking statins. All in all, half of all the people who been prescribed the drugs quit them at last temporarily. Twenty percent quit for more than a year.
Clinical trials of statins have reported low rates of side effects. But patient surveys conducted in real-world settings have found that as many as 15 percent of patients experience side effects.
The most common side effect is muscle soreness, fatigue or weakness.
The U.S. Food and Drug Administration and physicians continue to document that some patients experience fuzzy thinking and memory loss while taking statins, a class of global top-selling cholesterol-lowering drugs.
A University of Arizona research team has made a novel discovery in brain cells being treated with statin drugs: unusual swellings within neurons, which the team has termed the “beads-on-a-string” effect.
The team is not entirely sure why the beads form, said UA neuroscientist Linda L. Restifo, who leads the investigation. However, the team believes that further investigation of the beads will help inform why some people experience cognitive declines while taking statins.
“What we think we’ve found is a laboratory demonstration of a problem in the neuron that is a more severe version for what is happening in some peoples’ brains when they take statins,” said Restifo, a UA professor of neuroscience, neurology and cellular and molecular medicine, and principal investigator on the project.
Restifo and her team’s co-authored study and findings recently were published in Disease Models & Mechanisms, a peer-reviewed journal. Robert Kraft, a former research associate in the department of neuroscience, is lead author on the article.
At Loyola’s Lipid Clinic, a cardiologist who has received advanced training in lipidology (cholesterol management) performs an in-depth evaluation of a patient’s statin intolerance, and prepares an in-depth treatment regimen. Properly adjusting a patient’s medication can enable the patient to continue taking statins. The physician adjusts medication by, for example, switching to a different statin or changing the dose or frequency of the drug, Phan said.
Phan is medical director of Loyola’s Preventive Cardiology and Lipid Program. The program helps prevent heart attacks and other cardiac-related disorders and provides advanced treatment of cholesterol disorders.
Phan is an assistant professor in the Division of Cardiology of Loyola University Chicago Stritch School of Medicine.
Loyola University Health System