Effectiveness and tolerability of every-other-day rosuvastatin dosing in patients with prior statin intolerance.
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.
Backes
James M
JM
Department of Pharmacy Practice, Schools of Pharmacy and Medicine, University of KansasKansas City, KS 66160, USA. jbackes@kumc.edu
Venero
Carmelo V
CV
Gibson
Cheryl A
CA
Ruisinger
Janelle F
JF
Howard
Patricia A
PA
Thompson
Paul D
PD
Moriarty
Patrick M
PM
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
D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008074:Lipoproteins; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium