Evaluation of cases of severe statin-related transaminitis within a large health maintenance organization

Charles, E.C.; Olson, Kari L.; Sandhoff, Brian G.; McClure, David L.; Merenich, John A.

doi:10.1016/j.amjmed.2005.02.008

Cited by 64 publications

(43 citation statements)

References 15 publications

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“…In this study, statin-related severe transaminitis occurred infrequently. These findings support less frequent liver enzyme monitoring for most patients on statins (50).…”

Section: Epidemiological Studies On Statinssupporting

confidence: 64%

Hepatotoxicity associated with statins

Karahalıl

Hare

Koç

et al. 2017

Archives of Industrial Hygiene and Toxicology

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Treatment with statins is known all over the world. They are generally considered safe at therapeutic doses. Nevertheless, clinical trials are not enough to assess their scarce adverse effects such as idiosyncratic drug induced liver injury (DILI). Due to some conditions, such as concomitant usage (drug-drug interaction using an identical metabolising enzyme) and genetic polymorphisms, there is an increasing concern about their safety. Hepatotoxicity and rhabdomyolysis have begun to appear in published studies. Most of investigations have focused on both these adverse effects and mechanisms of drug induced toxicity. The present review has attempted to compile almost all of the existing studies on the hepatotoxicity of statins but not rhabdomyolysis. The aim of our study is to provide an overview of the studies on the statin-associated hepatotoxicity and to discuss the published studies. The researchers are of the opinion that the research on this topic is incomplete but extremely necessary.

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“…In this study, statin-related severe transaminitis occurred infrequently. These findings support less frequent liver enzyme monitoring for most patients on statins (50).…”

Section: Epidemiological Studies On Statinssupporting

confidence: 64%

Hepatotoxicity associated with statins

Karahalıl

Hare

Koç

et al. 2017

Archives of Industrial Hygiene and Toxicology

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“…61,62 In an evaluation of cases of severe statin-related transaminitis within a large health maintenance organization, 0.1% of 23 000 patients had severe transaminitis deemed directly attributable to statin use. 63 In practice, clinicians frequently follow muscular and hepatic serum markers in asymptomatic patients on statin therapy. In a previous report, however, Smith et al 64 failed to find any efficacy in routine screening of serum CK and transaminases in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Risks Associated With Statin Therapy

Kashani

Phillips²,

Foody³

et al. 2006

Circulation

421

129

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“…33 In a retrospective analysis of a large insured population in the United States, 23,000 patients received statins. 34 Of these patients, 2% exhibited ALT exceeding 3Â ULN and 0.1% (17/23,000) exhibited symptomatic hepatitis and statin-related ALT exceeding 10Â ULN (with most occurring within 4 weeks of therapy initiation). Among those patients with ALT exceeding 10Â ULN with initial statin treatment, 10 were rechallenged with the same statin.…”

Section: Resultsmentioning

confidence: 99%

“…34 With statin cessation, liver chemistry elevations resolved within 2-8 weeks. Reactive metabolite 32 20-160 mg 26 Atorvastatin, simvastatin, lovastatin (n ¼ 10) 34 30% 34 Decreases mitochondrial membrane potential; inhibits fatty acid beta-oxidation 36 ; uncouples electron transport from phosphorylation 37 Atorvastatin electrophilic acyl glucuronide metabolite 35 20-80 mg 26 Isoniazid, rifampin, pyrazinamide (n ¼ 220) 6 Statin injury is predominantly hepatocellular. 33 The formation of electrophilic metabolites covalently binding to proteins is frequently implicated in immunebased hepatotoxicity; an electrophilic acyl glucuronide metabolite has been reported for atorvastatin.…”

Section: Resultsmentioning

confidence: 99%