# Statins Appear Well Tolerated in Most Patients who Restart Treatment After Discontinuation for Statin-Related Adverse Events

 

 

      EBM Focus - Volume 8, Issue 16 

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Reference: [Ann Intern Med 2013 Apr 2;158(7):526](http://r20.rs6.net/tn.jsp?e=001MyvmMgDCbb50KsqG5Hjy4DstL6IAD34hFUH29q8QGWBw2AAU8XYzWL3LVkkA3wZny-qgLd2N-y3Cp3e9EFqcbjP2ItJj3i5FAD7JF7UALGaXAbDzV1vb9LQ2U0q5jaA3ouvAFCGeEAeDwKEhoN1vgA9A47mD8LEM-zOE7YQUY9-TIelPctwwhmV2qBBrb4n3sxHYUWDQQOOk8DVYK9YzKLXVQAdQXKYjQxxEmC22-4A=)

Statin therapy has been shown to be effective for both primary and secondary cardiovascular disease prevention ([Cochrane Database Syst Rev 2013 Jan 31;(1):CD004816](http://r20.rs6.net/tn.jsp?e=001MyvmMgDCbb50KsqG5Hjy4DstL6IAD34hFUH29q8QGWBw2AAU8XYzWL3LVkkA3wZny-qgLd2N-y3Cp3e9EFqcbjP2ItJj3i5F-ahidRTO5FzwdMseMsqFbYyH3L8DMIf2K5wBDEogVsWiAQXzWnbekcLFNh1_FBuIdKnK6vtPKFFfrLKG1eFjXb8sCvhJk8rFA8xnAYsByfo=)) ([Arch Intern Med 2004 Jul 12;164(13):1427](http://r20.rs6.net/tn.jsp?e=001MyvmMgDCbb50KsqG5Hjy4DstL6IAD34hFUH29q8QGWBw2AAU8XYzWL3LVkkA3wZny-qgLd2N-y3Cp3e9EFqcbjP2ItJj3i5FAD7JF7UALGaXAbDzV1vb9LQ2U0q5jaA3ouvAFCGeEAeDwKEhoN1vgA9A47mD8LEM-zOE7YQUY9-TIelPctwwhmV2qBBrb4n3sxHYUWDQQONRtKHyxFZMZbd9lrsNH6PePPg4rNlZKgFeKbfBb31eFlZrZmnobnyur9MPCl18s6c=)), and discontinuation has been associated with increased event rates ([JAMA 2007 Jan 10;297(2):177](http://r20.rs6.net/tn.jsp?e=001MyvmMgDCbb50KsqG5Hjy4DstL6IAD34hFUH29q8QGWBw2AAU8XYzWL3LVkkA3wZny-qgLd2N-y3Cp3e9EFqcbjP2ItJj3i5FAD7JF7UALGaXAbDzV1vb9LQ2U0q5jaA3GNeYSvyJZjXt69ySG-wlfW95QBI90IqKPywiGgoj8eveOoAoXouNMUYIFS987eIzSACa01PhA1wCihKc60INcsaJVN_c-j5PPhr6urv_VHLJPpX5KzhYyBIWWW9WvLKSIOTuizwmFS8=)). Nevertheless, discontinuation is common, often due to adverse effects associated with statin treatment. A recent, retrospective cohort study investigated the rates of discontinuing and restarting statins in 107,835 patients who received prescriptions from 2000 to 2008.

Statin therapy was discontinued at least temporarily in 53% of patients overall, while only 17% experienced statin-related adverse events. Of those who did have events, 59% discontinued treatment. The most common events were myalgia and myopathy or other musculoskeletal or connective tissue disorders, pain and fatigue. A total of 6,579 patients who stopped statins due to a statin-related adverse event then restarted statins, with 41% restarting the same drug that had been discontinued. 92% of the patients restarting statins remained on treatment at 1 year after the original event. About a third of those who restarted on their original statin were taking the same or a higher dose at 1 year. Of the patients who discontinued for reasons other than adverse events and then restarted, 98% remained on treatment at 1 year after the original discontinuation.

These results suggest that the majority of patients who restart statins may find them tolerable over the long term, even if they have a history of adverse reactions. This information may help clinicians counsel patients regarding the risks and benefits of continued statin therapy.

For more information, see the [Statins](http://r20.rs6.net/tn.jsp?e=001MyvmMgDCbb50KsqG5Hjy4DstL6IAD34hFUH29q8QGWBw2AAU8XYzWL3LVkkA3wZnwQJZG7dN_B_hcU42Q7ZUeROPbXfjjLiV2TPpSOSHXSo06vzJNk9LBuWhVGMc74fbWdejGle3xn6Dflfc-jzl3_MX8O0V-d2yqYk1gJ5qTc1yvMsLuP6jK_h8Dwr4og2mu404cHQxHrF_d7kFXtAVluR5GXMIzDz9) topic in DynaMed.