Volume 15, Number 3, May-June 2008

Managing patients with ‘statin intolerance’: a retrospective study
Rajesh K Nair, Rangaprasad L Karadi, Eric S Kilpatrick

The incidence of statin intolerance due to non-severe side effects is estimated to be 5–10%. As an increasing number of patients become eligible for lipid-lowering treatment, this is becoming a more prevalent issue. Very limited, if any, data exist so far in the management of this subgroup of patients. Clinic letters from 1,100 patients who attended the Lipid Clinic at Hull Royal Infirmary from January 2000 until December 2004 were searched for ‘statin intolerance’. Forty patients (19 male, 21 female, median age 62 years) were identified with intolerance to at least one statin drug but with an absolute indication to be on treatment. Out of the 40 patients, 26 (65%, 11 male, 15 female) were eventually able to tolerate a statin for at least six months without their initial side effect, the most commonly successful statins being rosuvastatin (n=9) and pravastatin (n=8). Overall, this required a median of two switches (range one to four) in statin treatment. Fourteen (35%) were unable to continue treatment after a median of 1.5 switches (range one to three), either because of continued intolerance or a decision not to proceed with more alternatives. In conclusion, nearly two thirds of patients with initial problems with a particular statin are able to take an alternative statin without side effects. This supports the trial of different statins in intolerant patients.

Br J Cardiol 2008;15:158–60.

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