Navigating Statin Toxicities
Saturday, October 19 at 10:30 am and 11:30 am
LAS VEGAS—Striking a balance between the benefits and adverse effects of treatment is often challenging, particularly as it relates to statin therapy. In today’s presentation, “Navigating Statin Toxicities,” Louis Kuritzky, MD, clinical assistant professor at the University of Florida in Gainesville, shares tips and tricks for navigating the most frequent toxicities encountered with the best-selling prescription drug class in the U.S.
Attendees will learn how to recognize the most common statin-related toxicities seen in clinical practice, including myalgia, rhabdomyolysis, hepatotoxicity, and new-onset diabetes. Various case studies will illustrate how these conditions may present in clinical practice, and hypothetical case examples will prompt audience members to consider how they might proceed in their own practices.
Kuritzky will discuss the real and sometimes treatment-limiting adverse effects of statin-induced myalgias. Research has suggested that it’s beneficial to measure vitamin D levels in patients who complain of myalgia and replete as necessary. Augmentation with Coenzyme Q is also a consideration in patients with statin-induced myalgia.
The presentation will also explore recent concerns about a disproportionate increase in the risk of myopathy with high-dose simvastatin as well as the resulting label changes. These indicate that 80 mg per day should be restricted to patients who have used this dosage without myopathy for ≥ 12 months. While the patient is taking 80 mg per day, the prescribing clinician should switch to an alternative statin if the need arises to administer an interacting drug. And if 40 mg per day is insufficient for the patient, consider switching to a more potent statin, such as atorvastatin or rosuvastatin.
Kuritzky will also talk about how to determine when the risk of adverse events is outweighed by the potential cardiovascular protection in patients with dyslipidemia. In the case of statin-induced new-onset diabetes, for example, it’s generally felt that cardiovascular risk reduction outweighs the potential for this uncommon consequence of treatment. Evidence suggests that clinical practice in patients with moderate or high CV risk or existing CVD should not change.
The latest research has found that when individual statins were compared in a network meta-analysis of statin tolerability and harm in 135 trials, there were numerous statistically detectable differences, favoring simvastatin and pravastatin.
—Colleen Mullarkey