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Statin intolerance

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https://www.readbyqxmd.com/read/27897416/curcumin-an-effective-adjunct-in-patients-with-statin-associated-muscle-symptoms
#1
REVIEW
Amirhossein Sahebkar, Nikou Saboni, Matteo Pirro, Maciej Banach
In spite of the unequivocal efficacy of statins in reducing primary and secondary cardiovascular events, the use of these drugs in a considerable number of patients is limited because of statin intolerance, mainly statin-associated muscle symptoms (SAMS). SAMS encompass a broad spectrum of clinical presentations, including mild muscular aching and other types of myalgias, myopathy with the significant elevation of creatine kinase, and the rare but life-threatening rhabdomyolysis. Among several pathophysiologic mechanisms of SAMS, mitochondrial dysfunction is thought to be one of the main one...
September 22, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27888902/-unmet-needs-patients-with-statin-intolerance-or-familial-hypercholesterolemia
#2
Luis Masana, Fernando Civeira
The achievement of low-density lipoprotein (LDL) therapeutic targets is especially difficult in some patients at high cardiovascular risk. These patients include persons with statin intolerance and those with very high LDL cholesterol (LDLc) levels such as persons with familial hypercholesterolemia. The proportion of statin-intolerant patients is between 7% and 29%. Alternative lipid-lowering drugs (including ezetimibe) are less effective and are not free from adverse effects. Both alirocumab, with the ODYSSEY ALTERNATIVE study, and evolocumab, with the GAUSS study, have shown strong lipid-lowering efficacy, with much greater tolerability than currently available alternatives, with the result that a larger number of patients achieve therapeutic targets...
May 2016: Clínica e Investigación en Arteriosclerosis
https://www.readbyqxmd.com/read/27848220/evolocumab-for-treating-primary-hypercholesterolaemia-and-mixed-dyslipidaemia-an-evidence-review-group-perspective-of-a-nice-single-technology-appraisal
#3
REVIEW
Christopher Carroll, Paul Tappenden, Rachid Rafia, Jean Hamilton, Duncan Chambers, Mark Clowes, Paul Durrington, Nadeem Qureshi, Anthony S Wierzbicki
As part of its Single Technology Appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer of evolocumab (Amgen) to submit evidence on the clinical and cost effectiveness of evolocumab. The appraisal assessed evolocumab as monotherapy or in combination with a statin (HMG-CoA reductase inhibitor) with or without ezetimibe, or in combination with ezetimibe (without statin therapy), in adult patients with primary hypercholesterolaemia (which includes mixed dyslipidaemia), for whom statins do not provide optimal control of their low-density lipoprotein cholesterol (LDL-C) levels and/or for whom statins are contraindicated or not tolerated...
November 16, 2016: PharmacoEconomics
https://www.readbyqxmd.com/read/27805428/statin-myopathy-navigating-the-maze
#4
Christos V Rizos, Moses S Elisaf
Statins hold a central role in cardiovascular disease (CVD) prevention having proved both their efficacy and their safety. However, the development of side effects, most commonly muscle related symptoms, can lead to suboptimal treatment adhesion or even discontinuation. This translates to poor CVD risk management. As a result, it is imperative that physicians differentiate true statin-associated muscle symptoms (SAMS) from other causes as well as assess statin intolerance. Moreover, an alternative treatment strategy should be implemented for the management of these patients...
November 2, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27804896/investigating-cholesterol-metabolism-and-ageing-using-a-systems-biology-approach
#5
A E Morgan, K M Mooney, S J Wilkinson, N A Pickles, M T Mc Auley
CVD accounted for 27 % of all deaths in the UK in 2014, and was responsible for 1·7 million hospital admissions in 2013/2014. This condition becomes increasingly prevalent with age, affecting 34·1 and 29·8 % of males and females over 75 years of age respectively in 2011. The dysregulation of cholesterol metabolism with age, often observed as a rise in LDL-cholesterol, has been associated with the pathogenesis of CVD. To compound this problem, it is estimated by 2050, 22 % of the world's population will be over 60 years of age, in culmination with a growing resistance and intolerance to pre-existing cholesterol regulating drugs such as statins...
November 2, 2016: Proceedings of the Nutrition Society
https://www.readbyqxmd.com/read/27756478/effect-on-fasting-serum-glucose-levels-of-adding-ezetimibe-to-statins-in-patients-with-nondiabetic-hypercholesterolemia
#6
Peter P Toth, Alberico L Catapano, Michel Farnier, Joanne Foody, Joanne E Tomassini, Erin Jensen, Adam B Polis, Mary E Hanson, Thomas A Musliner, Andrew M Tershakovec
Statin therapy is associated with a slightly increased risk of developing diabetes mellitus and insulin resistance in patients without diabetes. Ezetimibe combined with statins may be considered for high-risk patients who do not achieve optimal low-density lipoprotein cholesterol lowering on statin monotherapy or who are statin intolerant. Changes in fasting serum glucose (FSG) levels during ezetimibe, ezetimibe/statin, and statin treatments were assessed using data pooled from clinical trials in hypercholesterolemic and heterozygous familial hypercholesterolemic patients, who were or were not receiving statin therapy...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27712714/development-and-validation-of-algorithms-to-identify-statin-intolerance-in-a-us-administrative-database
#7
Kathy L Schulman, Lois E Lamerato, Mehul R Dalal, Jennifer Sung, Mehul Jhaveri, Andrew Koren, Usha G Mallya, JoAnne M Foody
OBJECTIVES: To develop and validate algorithms to define statin intolerance (SI) in an administrative database using electronic medical records (EMRs) as the reference comparison. METHODS: One thousand adults with one or more qualifying changes in statin therapy and one or more previous diagnoses of hyperlipidemia, hypercholesterolemia, or mixed dyslipidemia were identified from the Henry Ford Health System administrative database. Data regarding statin utilization, comorbidities, and adverse effects were extracted from the administrative database and corresponding EMR...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27696318/statin-adherence-does-gender-matter
#8
Karen M Goldstein, Leah L Zullig, Lori A Bastian, Hayden B Bosworth
PURPOSE OF REVIEW: Cardiovascular disease (CVD) continues to be the leading cause of death for men and women in the USA. Statins have contributed significantly to noted declines in cardiovascular-related mortality in the last decade; however, the benefit of statins is inequitable across genders. Women continue to be less likely to take statins and to meet target LDL goals than men. As a possible contributing factor to this disparity, we explore the evidence for gender-based differences in provision of, and adherence to statins...
November 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27678435/familial-hypercholesterolemia-in-a-large-ambulatory-population-statin-use-optimal-treatment-and-identification-for-advanced-medical-therapies
#9
Thomas Knickelbine, Matthew Lui, Ross Garberich, Michael D Miedema, Craig Strauss, Jeffrey J VanWormer
BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal dominant genetic disease resulting in elevated serum low-density lipoprotein cholesterol (LDL-C) levels. Patients with FH have a very high lifetime risk of cardiovascular disease, but FH often goes unrecognized in clinical care. New treatments including PCSK9 inhibitors are now available for this population, and the use of the electronic record may be able to help identify potential patients for therapy. OBJECTIVES: The goal of this study was to determine the period prevalence of FH in a large ambulatory care population, including the homozygous form...
September 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27663902/bempedoic-acid-etc-1002-an-investigational-inhibitor-of-atp-citrate-lyase
#10
Ozlem Bilen, Christie M Ballantyne
Bempedoic acid (ETC-1002), a novel therapeutic approach for low-density lipoprotein cholesterol (LDL-C) lowering, inhibits ATP citrate lyase (ACL), an enzyme involved in fatty acid and cholesterol synthesis. Although rodent studies suggested potential effects of ACL inhibition on both fatty acid and cholesterol synthesis, studies in humans show an effect only on cholesterol synthesis. In phase 2 studies, ETC-1002 reduced LDL-C as monotherapy, combined with ezetimibe, and added to statin therapy, with LDL-C lowering most pronounced when ETC-1002 was combined with ezetimibe in patients who cannot tolerate statins...
October 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27661220/advances-in-the-field-of-proprotein-convertase-subtilisin-kexin-type-9-inhibitors
#11
Alon Eisen, Robert P Giugliano
PURPOSE OF REVIEW: Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors are promising therapies that inhibit the degradation of low-density lipoprotein (LDL) receptors in the hepatocyte and thus increase LDL cholesterol (LDL-C) uptake from the blood. This review summarizes main findings in the field of PCSK9 inhibitors, from basic mechanism to clinical studies, and aims to provide a contemporary and practical overview of the clinical implication and future directions with PCSK9 inhibitors...
November 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27660454/retargeting-the-management-of-hypercholesterolemia-focus-on-evolocumab
#12
REVIEW
Alessandro Colletti, Giuseppe Derosa, Arrigo Fg Cicero
Hypercholesterolemia is one of the main risk factors for atherosclerosis and cardiovascular diseases. The treatment is based on the modification of the diet and lifestyle and if necessary on a pharmacological therapy. The most widely used drugs are the inhibitors of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase (statins); nevertheless, many patients do not reach optimal levels of low-density lipoprotein-cholesterol (LDL-C) even with maximal dosage of statins (eventually associated to ezetimibe) or present side effects, which do not allow them to continue the treatment...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27645111/statin-intolerance-a-question-of-definition
#13
Engi Abdel-Hady Algharably, Iris Filler, Stephanie Rosenfeld, Katja Grabowski, Reinhold Kreutz
Introduction Statin therapy is the backbone of pharmacologic therapy for low-density lipoproteins cholesterol lowering and plays a pivotal role in cardiovascular disease prevention. Statin intolerance is understood as the inability to continue using a statin to reduce individual cardiovascular risk sufficiently, due to the development of symptoms or laboratory abnormalities attributable to the initiation or dose escalation of a statin. Muscle symptoms are the most common side effects observed. Areas covered The main aim of this article is to present a review on published definitions of statin intolerance...
September 19, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27633454/heart-score-estimation-by-specialized-nurses-in-a-greek-urban-population
#14
Evaggelia Papadopoulou, Maria Meidani, Maria Boutsikou, Pinelopi Papaspiropoulou, Theodosia Kelaiditou, Afedia Koukouzli, Anastasia Tapola, Ioanna Voudoufianaki, Sophie Mavrogeni, Niki Katsiki, Genovefa Kolovou, Ioannis Lekakis
AIMS: Specialized nurses estimated the HeartScore in an urban Greek population by recognizing cardiovascular disease (CVD) risk factors in the setting of the Onassis Cardiovascular Prevention Program (OCPP). They also provided nursing consultation and assessed the clinical and biochemical characteristics of the studied population. METHODS AND RESULTS: Individuals were recruited through TV announcements and via the website of the Onassis Cardiac Surgery Centre. All participants visited the Onassis Cardiac Centre from 20 September to 30 October 2011...
September 14, 2016: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/27620355/harder-to-treat-patients-recognizing-them-and-adapting-treatment-strategies
#15
Michael D Miedema, Salim S Virani
Despite significant progress in pharmacologic treatment aimed at lowering low-density lipoprotein cholesterol to reduce cardiovascular disease risk, a number of patient groups that often prove difficult to treat remain. Patients with familial hypercholesterolemia may go undiagnosed and untreated or, despite treatment, have persistently elevated lipid levels that confer a high cardiovascular disease risk. Although the true prevalence is unknown, statin intolerance is a common clinical presentation that is difficult to assess and frequently leads to suboptimal lipid treatment...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27578118/statin-intolerance-in-a-referral-lipid-clinic
#16
Wanda C Lakey, Nicole G Greyshock, Carly E Kelley, Mohammad A Siddiqui, Umar Ahmad, Yuliya V Lokhnygina, John R Guyton
BACKGROUND: Statins effectively prevent atherosclerotic cardiovascular disease, but rates of statin discontinuation after adverse events are high. OBJECTIVE: Describe the range and relative frequencies of adverse events potentially attributable to statins in lipid referral practice and assess statin rechallenge outcomes. METHODS: Retrospective cohort study of 642 patients with statin-associated adverse events evaluated in a referral lipid clinic between January 1, 2004 and January 27, 2011...
July 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27578103/the-nocebo-effect-in-the-context-of-statin-intolerance
#17
EDITORIAL
Jonathan A Tobert, Connie B Newman
The nocebo effect, the inverse of the placebo effect, is a well-established phenomenon that is under-appreciated in cardiovascular medicine. It refers to adverse events, usually purely subjective, that result from expectations of harm from a drug, placebo, other therapeutic intervention or a nonmedical situation. These expectations can be driven by many factors including the informed consent form in a clinical trial, warnings about adverse effects communicated by clinicians when prescribing a drug, and information in the media about the dangers of certain treatments...
July 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27567901/management-of-hypercholesterolemia-appropriateness-of-therapeutic-approaches-and-new-drugs-in-patients-with-high-cardiovascular-risk
#18
Enrico Agabiti Rosei, Massimo Salvetti
Control of lipid levels is one of the most effective strategies for cardiovascular (CV) event prevention. In fact, many clinical trials have clearly demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, primarily with statins, reduces major CV events and mortality. The evidence from these trials has been useful in designing the cholesterol treatment guidelines, which are mainly aimed at preventing and managing cardiovascular disease (CVD). However, available data indicate that a large proportion of patients fail to achieve lipid goals, and this is particularly frequent in patients at high or very high CV risk...
September 2016: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/27533061/from-proprotein-convertase-subtilisin-kexin-type-9-to-its-inhibition-state-of-the-art-and-clinical-implications
#19
REVIEW
Eliano P Navarese, Michalina Kołodziejczak, Dimitrios Dimitroulis, Georg Wolff, Hans L Busch, Fiorella Devito, Alessandro Sionis, Marco Matteo Ciccone
Statins are recommended as first-line therapy for patients with hypercholesterolaemia. A sizable proportion of patients, however, does not reach therapeutic goals, is statin intolerant, or, despite optimal statin therapy, is at high risk of ischaemic events. Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a major role in lipid metabolism and several comorbidities. Monoclonal antibodies targeting PCSK9 are a new lipid-lowering approach with the potential to improve clinical outcomes in patients with dyslipidaemia...
January 2016: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/27502861/evaluating-bococizumab-a-monoclonal-antibody-to-pcsk9-on-lipid-levels-and-clinical-events-in-broad-patient-groups-with-and-without-prior-cardiovascular-events-rationale-and-design-of-the-studies-of-pcsk9-inhibition-and-the-reduction-of-vascular-events-spire
#20
Paul M Ridker, Pierre Amarenco, Robert Brunell, Robert J Glynn, J Wouter Jukema, John J P Kastelein, Wolfgang Koenig, Steven Nissen, James Revkin, Raul D Santos, Pamela F Schwartz, Carla Yunis, Jean-Claude Tardif
BACKGROUND: Although statins significantly reduce vascular event rates, residual cholesterol risk remains high in many patient groups, including those with known vascular disease as well as in the setting of high-risk primary prevention. Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9), prolongs the half-life of hepatic low-density lipoprotein (LDL) receptors, and reduces circulating atherogenic cholesterol levels. DESIGN: The SPIRE program comprises 6 lipid-lowering studies and 2 cardiovascular outcomes trials, each comparing bococizumab (150 mg subcutaneously every 2 weeks) to matching placebo...
August 2016: American Heart Journal
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