Statin-Associated Adverse Events

Yuet, Wei Cheng; Khine, Htet; Ahmad, Zahid

doi:10.4137/cmt.s18865

Cited by 3 publications

(3 citation statements)

References 94 publications

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“…80 In contrast to above one observational study in unselected population of 7924 patients with hyperlipidemia (France) reported that 14.9% of patients receiving atorvastatin 40-80 mg experienced muscle symptoms 6 and the prevalence of muscle related adverse events was considered to increase 4 to 5 fold when dose of atorvastatin was increased from 40 to 80 mg. 80 A meta analysis of 19 randomized statin trials comparing standard doses of all statins except rosuvastatin accounted that fluvastatin was associated with the lowest rate of myopathy compared to other statin. 81 The rosuvastatin dose upto 40 mg have no muscle toxicity but the higher doses appeared to be associated with increased risk of myopathy.…”

Section: High Dose/ Individual Drug Effectmentioning

confidence: 90%

Untitled

2016

IJPSR

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Statins, 3-hydroxymethyl-3-methylglutaryl coenzyme A reductase inhibitors, are considered safe in lowering hyperlipidemia and cardiovascular disease. Statin attempt to reduce cholesterol production in liver in dose dependent manner not only cause the muscle related problem but also leads to other untoward consequence like arthritis, diabetes, neurological disorders which arise as a result of scarcity in cholesterol production. Discontinuation or reduction in the dose of the statin usually leads to resolution of these side effects but the efficacy is questionable. Though the statin had come to market several decades ago, their harmful effects have been well understood very recently only after several randomized trials. The pleiotropic effects of statin have reported many benefits, but lack of randomized clinical trials make it limit to extend its indication beyond lipid lowering effects. There is still a controversy between their benefits and adverse effects of statin. The upcoming research should focus to resolve the above said confliction that could overcome its most adverse events-myopathy. If it so the statin with pleiotropic effect without any myopathic symptoms would be an excellent candidate among all other drugs. In this review, we discussed the myotoxicity, mechanism of myopathy, consequences as a result of statin"s attempt to reduce cholesterol production, risk factors for myopathy.

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Section: High Dose/ Individual Drug Effectmentioning

confidence: 90%

Untitled

2016

IJPSR

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“…Although statins have revolutionized the treatment of hypercholesterolemia by inhibiting 3-hydroxy-3-methylglutaryl coenzyme-A reductase, some side effects of oral symptoms have been documented [ 5 – 8 ]. In another study [ 9 ], 17 out of 26 hypercholesterolemia patients between the ages of 50 and 70 with oral symptoms reported relief after controlled 7- and 15-day trials of the suspension of statins.…”

Section: Discussionmentioning

confidence: 99%

Rosuvastatin-Induced Oral Ulcer: A Case Report and Review of Literature

Algeffari

Alsharidah

2022

Case Reports in Dentistry

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Background. The benefits of prescribing statins are well published in the treatment of hypercholesterolemia. With such widespread usage of statins, physicians may be ignoring or misdiagnosing the association of oral side effects with these medications. Case Summary. A 54-year-old man presented with a painful ulceration on the dorsum of his tongue that had been recurring for 10 months. Originally, he experienced a burning sensation on his tongue, and as the lesion advanced, the pain became more intense specially when consuming spicy or acidic foods. He is on rosuvastatin for the treatment of hypercholesterolemia for over five years. Several months prior to the lesion forming, his physician increased his daily dosage of rosuvastatin from 10 mg to 20 mg. Four weeks later at a follow-up appointment, all workup did not show any significant findings, the examination revealed a new ulcer on the dorsum of the tongue, and he reported no improvement after antifungal lozenges, nor when administered a short one-week treatment with oral steroids. After eight weeks of statin discontinued, the patient showed improvement with no episodes of ulceration. Conclusion. Physicians do note that statins affect multiple immunological pathways, which could explain some adverse cutaneous reactions. More research is needed in discovering the link of statins and oral disorders.

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“…[2][3][4][5] However, widespread use of statins has also resulted in several reported adverse events including muscle symptoms, incident diabetes, and cognitive impairment. 6 Following review of the Adverse Event Reporting System database and other published literature in 2012, the US Food and Drug Administration (FDA) issued statin label warnings for reversible cognitive adverse events such as cognitive dysfunction, confusion, and memory impairment. 7 The correlation between intense LDL-C reduction and neurocognitive adverse events remains unclear, but a proposed mechanism is that the inhibition of cholesterol synthesis may affect the essential functions of neurons whose cell membranes and myelin consists of cholesterol and other lipids.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive effects associated with proprotein convertase subtilisin-kexin type 9 inhibitor use: a narrative review

Yuet

Ebert

Jann

2021

Therapeutic Advances in Drug Safety

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Neurocognitive adverse events have been observed with the widespread use of 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors or “statins,” which reduce low-density lipoprotein cholesterol (LDL-C) levels and subsequently cardiovascular risk. The United States Food and Drug Association directed manufacturers of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors to monitor for neurocognitive adverse events due to their potent effects on LDL-C reduction, which is a proposed mechanism for neuronal cell dysfunction. Other proposed mechanisms for PCSK9 inhibitor-associated neurocognitive adverse events include N-methyl-d-aspartate receptor modulation, dysregulation of lipid and glucose metabolism, and patient-specific risk factors for cognitive impairment. The purpose of this narrative review article is to describe the proposed mechanisms, incidence of neurocognitive adverse events from phase II and III trials for PCSK9 inhibitors, neurocognitive assessments utilized in clinical trials, and clinical implications. Given the increasing prevalence of PCSK9 inhibitor use and the neurocognitive adverse events observed with prior lipid-lowering therapies, clinicians should be aware of the risks associated with PCSK9 inhibitors, especially when therapy is indicated for patients at high risk for cardiovascular events. Overall, the incidence of PCSK9 inhibitor-associated neurocognitive appears to be uncommon. However, additional prospective studies evaluating cognitive impairment may be beneficial to determine the long-term safety of these agents.

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Statin-Associated Adverse Events

Cited by 3 publications

References 94 publications

Untitled

Untitled

Rosuvastatin-Induced Oral Ulcer: A Case Report and Review of Literature

Neurocognitive effects associated with proprotein convertase subtilisin-kexin type 9 inhibitor use: a narrative review

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