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Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel

Identifieur interne : 002438 ( Ncbi/Curation ); précédent : 002437; suivant : 002439

Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel

Auteurs : Maciej Banach [Pologne] ; Manfredi Rizzo [Italie] ; Peter P. Toth [États-Unis] ; Michel Farnier [France] ; Michael H. Davidson [États-Unis] ; Khalid Al-Rasadi [Oman] ; Wilbert S. Aronow [États-Unis] ; Vasilis Athyros [Grèce] ; Dragan M. Djuric [Serbie] ; Marat V. Ezhov [Russie] ; Robert S. Greenfield [États-Unis] ; G. Kees Hovingh [Pays-Bas] ; Karam Kostner [Australie] ; Corina Serban [Roumanie] ; Daniel Lighezan [Roumanie] ; Zlatko Fras [Slovénie] ; Patrick M. Moriarty [États-Unis] ; Paul Muntner [États-Unis] ; Assen Goudev [Bulgarie] ; Richard Ceska [République tchèque] ; Stephen J. Nicholls [Australie] ; Marlena Broncel [Pologne] ; Dragana Nikolic [Italie] ; Daniel Pella [Slovaquie] ; Raman Puri [Inde] ; Jacek Rysz [Pologne] ; Nathan D. Wong [États-Unis] ; Laszlo Bajnok [Hongrie] ; Steven R. Jones [États-Unis] ; Kausik K. Ray [Royaume-Uni] ; Dimitri P. Mikhailidis [Royaume-Uni]

Source :

RBID : PMC:4379380

Abstract

Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin associated muscle symptoms (SAMS), and avoided the use of the term ‘statin intolerance’. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10–15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.


Url:
DOI: 10.5114/aoms.2015.49807
PubMed: 25861286
PubMed Central: 4379380

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PMC:4379380

Le document en format XML

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<region type="state">Illinois</region>
</placeName>
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</author>
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<name sortKey="Farnier, Michel" sort="Farnier, Michel" uniqKey="Farnier M" first="Michel" last="Farnier">Michel Farnier</name>
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<nlm:aff id="AF0004">Department of Lipidology, Point Medical, Dijon, France</nlm:aff>
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<name sortKey="Davidson, Michael H" sort="Davidson, Michael H" uniqKey="Davidson M" first="Michael H." last="Davidson">Michael H. Davidson</name>
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<nlm:aff id="AF0005">Department of Medicine, University of Chicago Medicine, Chicago, IL, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Medicine, University of Chicago Medicine, Chicago, IL</wicri:regionArea>
<placeName>
<region type="state">Illinois</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Al Rasadi, Khalid" sort="Al Rasadi, Khalid" uniqKey="Al Rasadi K" first="Khalid" last="Al-Rasadi">Khalid Al-Rasadi</name>
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<nlm:aff id="AF0006">Department of Clinical Biochemistry, SQUH, Muscat, Oman</nlm:aff>
<country xml:lang="fr">Oman</country>
<wicri:regionArea>Department of Clinical Biochemistry, SQUH, Muscat</wicri:regionArea>
<wicri:noRegion>Muscat</wicri:noRegion>
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<author>
<name sortKey="Aronow, Wilbert S" sort="Aronow, Wilbert S" uniqKey="Aronow W" first="Wilbert S." last="Aronow">Wilbert S. Aronow</name>
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<nlm:aff id="AF0007">Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York</wicri:regionArea>
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<region type="state">État de New York</region>
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<name sortKey="Athyros, Vasilis" sort="Athyros, Vasilis" uniqKey="Athyros V" first="Vasilis" last="Athyros">Vasilis Athyros</name>
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<nlm:aff id="AF0008">Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece</nlm:aff>
<country xml:lang="fr">Grèce</country>
<wicri:regionArea>Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki</wicri:regionArea>
<wicri:noRegion>Thessaloniki</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Djuric, Dragan M" sort="Djuric, Dragan M" uniqKey="Djuric D" first="Dragan M." last="Djuric">Dragan M. Djuric</name>
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<nlm:aff id="AF0009">Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia</nlm:aff>
<country xml:lang="fr">Serbie</country>
<wicri:regionArea>Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Belgrade</wicri:regionArea>
<wicri:noRegion>Belgrade</wicri:noRegion>
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<author>
<name sortKey="Ezhov, Marat V" sort="Ezhov, Marat V" uniqKey="Ezhov M" first="Marat V." last="Ezhov">Marat V. Ezhov</name>
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<nlm:aff id="AF0010">Department of Atherosclerosis, Cardiology Research Center, Moscow, Russia</nlm:aff>
<country xml:lang="fr">Russie</country>
<wicri:regionArea>Department of Atherosclerosis, Cardiology Research Center, Moscow</wicri:regionArea>
<placeName>
<settlement type="city">Moscou</settlement>
<region>District fédéral central</region>
</placeName>
</affiliation>
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<author>
<name sortKey="Greenfield, Robert S" sort="Greenfield, Robert S" uniqKey="Greenfield R" first="Robert S." last="Greenfield">Robert S. Greenfield</name>
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<nlm:aff id="AF0011">California Heart Associates, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>California Heart Associates, CA</wicri:regionArea>
<placeName>
<region type="state">Californie</region>
</placeName>
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</author>
<author>
<name sortKey="Hovingh, G Kees" sort="Hovingh, G Kees" uniqKey="Hovingh G" first="G. Kees" last="Hovingh">G. Kees Hovingh</name>
<affiliation wicri:level="4">
<nlm:aff id="AF0012">Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam</wicri:regionArea>
<placeName>
<settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
<settlement type="city">Amsterdam</settlement>
</placeName>
<orgName type="university">Université d'Amsterdam</orgName>
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<author>
<name sortKey="Kostner, Karam" sort="Kostner, Karam" uniqKey="Kostner K" first="Karam" last="Kostner">Karam Kostner</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0013">Mater Hospital, University of Queensland, St Lucia, QLD, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Mater Hospital, University of Queensland, St Lucia, QLD</wicri:regionArea>
<wicri:noRegion>QLD</wicri:noRegion>
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</author>
<author>
<name sortKey="Serban, Corina" sort="Serban, Corina" uniqKey="Serban C" first="Corina" last="Serban">Corina Serban</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0014">University of Medicine and Pharmacy “Victor Babes” Timisoara, Romania</nlm:aff>
<country xml:lang="fr">Roumanie</country>
<wicri:regionArea>University of Medicine and Pharmacy “Victor Babes” Timisoara</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Lighezan, Daniel" sort="Lighezan, Daniel" uniqKey="Lighezan D" first="Daniel" last="Lighezan">Daniel Lighezan</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0014">University of Medicine and Pharmacy “Victor Babes” Timisoara, Romania</nlm:aff>
<country xml:lang="fr">Roumanie</country>
<wicri:regionArea>University of Medicine and Pharmacy “Victor Babes” Timisoara</wicri:regionArea>
</affiliation>
</author>
<author>
<name sortKey="Fras, Zlatko" sort="Fras, Zlatko" uniqKey="Fras Z" first="Zlatko" last="Fras">Zlatko Fras</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0015">Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia</nlm:aff>
<country xml:lang="fr">Slovénie</country>
<wicri:regionArea>Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana</wicri:regionArea>
<wicri:noRegion>Ljubljana</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Moriarty, Patrick M" sort="Moriarty, Patrick M" uniqKey="Moriarty P" first="Patrick M." last="Moriarty">Patrick M. Moriarty</name>
<affiliation wicri:level="2">
<nlm:aff id="AF0016">Department of Medicine, Schools of Pharmacy and Medicine, The University of Kansas Medical Center, Kansas City, KS, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Medicine, Schools of Pharmacy and Medicine, The University of Kansas Medical Center, Kansas City, KS</wicri:regionArea>
<placeName>
<region type="state">Kansas</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Muntner, Paul" sort="Muntner, Paul" uniqKey="Muntner P" first="Paul" last="Muntner">Paul Muntner</name>
<affiliation wicri:level="2">
<nlm:aff id="AF0017">Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL</wicri:regionArea>
<placeName>
<region type="state">Alabama</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Goudev, Assen" sort="Goudev, Assen" uniqKey="Goudev A" first="Assen" last="Goudev">Assen Goudev</name>
<affiliation wicri:level="3">
<nlm:aff id="AF0018">Department of Cardiology, Queen Giovanna University Hospital, Sofia, Bulgaria</nlm:aff>
<country xml:lang="fr">Bulgarie</country>
<wicri:regionArea>Department of Cardiology, Queen Giovanna University Hospital, Sofia</wicri:regionArea>
<placeName>
<settlement type="city">Sofia</settlement>
<region nuts="2">Sofia-ville (oblast)</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ceska, Richard" sort="Ceska, Richard" uniqKey="Ceska R" first="Richard" last="Ceska">Richard Ceska</name>
<affiliation wicri:level="3">
<nlm:aff id="AF0019">3
<sup>rd</sup>
Department of Internal Medicine, Charles University, Praha, Czech Republic</nlm:aff>
<country xml:lang="fr">République tchèque</country>
<wicri:regionArea> Department of Internal Medicine, Charles University, Praha</wicri:regionArea>
<placeName>
<settlement type="city">Prague</settlement>
<region type="région" nuts="2">Bohême centrale</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Nicholls, Stephen J" sort="Nicholls, Stephen J" uniqKey="Nicholls S" first="Stephen J." last="Nicholls">Stephen J. Nicholls</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0020">South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>South Australian Health and Medical Research Institute and University of Adelaide, Adelaide</wicri:regionArea>
<wicri:noRegion>Adelaide</wicri:noRegion>
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</author>
<author>
<name sortKey="Broncel, Marlena" sort="Broncel, Marlena" uniqKey="Broncel M" first="Marlena" last="Broncel">Marlena Broncel</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0021">Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz</wicri:regionArea>
<wicri:noRegion>Medical University of Lodz</wicri:noRegion>
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</author>
<author>
<name sortKey="Nikolic, Dragana" sort="Nikolic, Dragana" uniqKey="Nikolic D" first="Dragana" last="Nikolic">Dragana Nikolic</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0002">Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea>Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo</wicri:regionArea>
<wicri:noRegion>Palermo</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pella, Daniel" sort="Pella, Daniel" uniqKey="Pella D" first="Daniel" last="Pella">Daniel Pella</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0022">First Department Of Internal Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, Košice, Slovakia</nlm:aff>
<country xml:lang="fr">Slovaquie</country>
<wicri:regionArea>First Department Of Internal Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, Košice</wicri:regionArea>
<wicri:noRegion>Košice</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Puri, Raman" sort="Puri, Raman" uniqKey="Puri R" first="Raman" last="Puri">Raman Puri</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0023">I P Apollo Hospital, New Delhi, India</nlm:aff>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>I P Apollo Hospital, New Delhi</wicri:regionArea>
<wicri:noRegion>New Delhi</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Rysz, Jacek" sort="Rysz, Jacek" uniqKey="Rysz J" first="Jacek" last="Rysz">Jacek Rysz</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0001">Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz</wicri:regionArea>
<wicri:noRegion>Lodz</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Wong, Nathan D" sort="Wong, Nathan D" uniqKey="Wong N" first="Nathan D." last="Wong">Nathan D. Wong</name>
<affiliation wicri:level="2">
<nlm:aff id="AF0024">Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA</wicri:regionArea>
<placeName>
<region type="state">Californie</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Bajnok, Laszlo" sort="Bajnok, Laszlo" uniqKey="Bajnok L" first="Laszlo" last="Bajnok">Laszlo Bajnok</name>
<affiliation wicri:level="1">
<nlm:aff id="AF0025">First Department of Medicine, University of Pecs, Pecs, Hungary</nlm:aff>
<country xml:lang="fr">Hongrie</country>
<wicri:regionArea>First Department of Medicine, University of Pecs, Pecs</wicri:regionArea>
<wicri:noRegion>Pecs</wicri:noRegion>
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</author>
<author>
<name sortKey="Jones, Steven R" sort="Jones, Steven R" uniqKey="Jones S" first="Steven R." last="Jones">Steven R. Jones</name>
<affiliation wicri:level="2">
<nlm:aff id="AF0026">The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD</wicri:regionArea>
<placeName>
<region type="state">Maryland</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Ray, Kausik K" sort="Ray, Kausik K" uniqKey="Ray K" first="Kausik K." last="Ray">Kausik K. Ray</name>
<affiliation wicri:level="3">
<nlm:aff id="AF0027">Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Primary Care and Public Health, School of Public Health, Imperial College London, London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Mikhailidis, Dimitri P" sort="Mikhailidis, Dimitri P" uniqKey="Mikhailidis D" first="Dimitri P." last="Mikhailidis">Dimitri P. Mikhailidis</name>
<affiliation wicri:level="3">
<nlm:aff id="AF0028">Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London</wicri:regionArea>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
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</author>
</analytic>
<series>
<title level="j">Archives of Medical Science : AMS</title>
<idno type="ISSN">1734-1922</idno>
<idno type="eISSN">1896-9151</idno>
<imprint>
<date when="2015">2015</date>
</imprint>
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</teiHeader>
<front>
<div type="abstract" xml:lang="en">
<p>Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin associated muscle symptoms (SAMS), and avoided the use of the term ‘statin intolerance’. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10–15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.</p>
</div>
</front>
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