Rechallenging Statin Therapy in Veterans With Statin-Induced Myopathy Post Vitamin D Replenishment
| Autor: | Jenny H. Kang, Quang A. Le, Juleann Mutka, Quynh-Nhu Nguyen |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Statin Outpatient Clinics Hospital medicine.drug_class Hospitals Veterans 030204 cardiovascular system & hematology vitamin D deficiency Cohort Studies 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Muscular Diseases Internal medicine medicine Vitamin D and neurology Humans Pharmacology (medical) 030212 general & internal medicine Vitamin D Adverse effect Aged Retrospective Studies Veterans biology Cholesterol business.industry nutritional and metabolic diseases Middle Aged medicine.disease Vitamin D Deficiency Statin induced myopathy Endocrinology chemistry HMG-CoA reductase biology.protein lipids (amino acids peptides and proteins) Female Statin therapy Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
| Zdroj: | Journal of pharmacy practice. 30(5) |
| ISSN: | 1531-1937 |
| Popis: | Background: Statins are the primary class of medications used to lower cholesterol and reduce risks for coronary heart disease. However, statin muscular adverse effects are one of the main reasons for statin nonadherence and a barrier to cardiovascular risk reduction. Objectives: The primary objective of our study was to examine the effect of replenishing vitamin D on statin-induced myopathy in veteran patients who failed to maintain statin therapy in a pharmacist-run ambulatory care setting. Secondary objectives were to examine changes in patients’ vitamin D levels, fasting lipid profiles, and achievement of lipid goals after reinitiation of statin therapy. Methods: This was a retrospective cohort study of veteran patients conducted at a pharmacist-managed cholesterol-optimization clinic. Patients with low-serum vitamin D, history of statin-induced myopathy, and who received vitamin D replenishment prior to rechallenging statin therapy between December 1, 2008, and April 1, 2015, were identified. The primary outcome was the percentage of patients who maintained their statin therapy at 12 months after statin reinitiation. Results: Twenty-seven patients met the study criteria. All patients were able to maintain their statin therapy without myalgia after vitamin D supplementation. Eleven patients (40.7%) tolerated their previously failed statins. The most frequently restarted statins were atorvastatin, pravastatin, and rosuvastatin. A 22% to 30% increase in the number of patients who achieved cholesterol goals based on the national lipid guidelines was observed at 12-month follow-up. Conclusion: Replenishing low vitamin D in patients with statin-induced myopathy appears to be an effective strategy in improving medication adherence and subsequently preventing cardiovascular and mortality events. |
| Databáze: | OpenAIRE |
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