title: Effectiveness and tolerability of every-other-day rosuvastatin dosing in patients with prior statin intolerance.
abstract: BACKGROUND
  Statins are generally well tolerated, but some patients discontinue therapy secondary to adverse effects. Dosing a statin (rosuvastatin) every other day (EOD) may provide significant lipoprotein changes while avoiding common adverse effects in this statin-intolerant population.
  
  
  OBJECTIVE
  To determine the effect and tolerance of EOD rosuvastatin in patients previously intolerant to statin therapy.
  
  
  METHODS
  We performed a retrospective analysis of patients treated with EOD rosuvastatin at 2 lipid specialty clinics: the University of Kansas Lipid, Atherosclerosis, and LDL-Apheresis Center and the Hartford Hospital Cholesterol Management Center. Approximately 2600 charts were reviewed to identify patients receiving rosuvastatin EOD who previously had experienced statin intolerance. Fifty-one patients were eligible for the analysis, which evaluated changes in the lipid profile, the number achieving their low-density lipoprotein cholesterol (LDL-C) goals, and the percent tolerating rosuvastatin EOD. Laboratory data were assessed immediately prior to rosuvastatin EOD therapy and at the first follow-up.
  
  
  RESULTS
  Myalgias (76.5%) and increased transaminase levels (19.5%) were the most common causes of prior statin intolerance, but 72.5% (37/51) of patients were able to tolerate the EOD therapy (mean dose 5.6 mg) regimen for 4 +/- 2.9 (mean +/- SD) months. Mean LDL-C decreased 34.5% (p < 0.001) in the patients who tolerated the regimen, enabling approximately 50% to achieve their LDL-C goal. All patients who were considered to be intolerant to rosuvastatin EOD therapy (27.5%; 14/51) re-experienced the symptoms of their prior statin intolerance.
  
  
  CONCLUSIONS
  Treating patients intolerant to statins with rosuvastatin EOD was tolerated by the majority of patients and reduced LDL-C in our study. This dosing strategy may be useful in patients intolerant to once-daily statin dosing, although such an approach has not been documented to reduce cardiovascular events.
authors.affiliation: Department of Pharmacy Practice, Schools of Pharmacy and Medicine, University of KansasKansas City, KS 66160, USA. jbackes@kumc.edu
authors.forename: James M
authors.initials: JM
authors.lastname: Backes
authors.forename: Carmelo V
authors.initials: CV
authors.lastname: Venero
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Gibson
authors.forename: Janelle F
authors.initials: JF
authors.lastname: Ruisinger
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Howard
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Moriarty
mesh_terms: D000368:Aged; D004334:Drug Administration Schedule; D015673:Fatigue Syndrome, Chronic / Q000097:blood / Q000139:chemically induced; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage* / Q000009:adverse effects*; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage* / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium