Most persons who stopped taking statins due to health events attributed to the drugs can tolerate these agents long-term when they try again, a recent study indicates. 


Researchers investigated the reasons for statin discontinuation and the role of statin-related events in routine care settings.1 Of 107,835 adults who received statin prescriptions from January 2000 through December 2008, 57,292 stopped using the drugs at least temporarily. Statin-related events had been documented for 18,778 (17.4%) of those who discontinued use.


More than half (6,579) of 11,124 persons who stopped taking statins at least temporarily due to such events were rechallenged with a statin over the subsequent 12 months. Nearly all of the rechallenged patients (92.2%) were still taking a statin 12 months later. Of the 2,721 patients who were rechallenged with the same statin to which they had a statin-related event, 1,295 were taking the same one 12 months later, and 996 of them were doing so at the same or a higher dose.


The findings suggest that many statin-related events may have other causes, are tolerable, or may be specific to individual statins rather than to the entire drug class. 


Separate research raised the possibility that clinicians are not adequately considering a patient’s cardiovascular risk when prescribing statins in primary prevention. Surveys from 202 physicians showed that when faced with persons at risk for coronary heart disease, practitioners consider medication for persons with low Framingham risk scores for whom available evidence does not support outcome benefitNi.
2

Interestingly, overuse of statins may be driven in part by television commercials. Jeff Niederdeppe, PhD, and colleagues reported in Journal of General Internal Medicine that their analysis of data provided new evidence that direct-to-consumer advertising may promote overdiagnosis of high cholesterol and overtreatment for populations in whom risks of statin use may outweigh benefits.3


The team estimated that exposure to television ads for statins increased the odds of being diagnosed with high cholesterol by 16% to 20%, and increased statin use by 16% to 22%. The associations were driven almost exclusively by men and women at low risk for future cardiac events.


References

  1. Zhang H et al. Ann Intern Med. 2013;158(7):526-534.
  2. Johansen ME et al. JAMA Intern Med. 2013;173(7):586-588.
  3. J Gen Intern Med. 2013; doi:10.1007/s11606-013-2379-3.