title: The Risk of Hepatotoxicity, New Onset Diabetes and Rhabdomyolysis in the Era of High-Intensity Statin Therapy: Does Statin Type Matter?
abstract: The 2013 American College of Cardiology/American Heart Association guidelines on cholesterol management have placed greater emphasis on high-intensity statin dosing for those with known cardiovascular disease or diabetes mellitus. Differences in risk of hepatotoxicity, new onset diabetes and rhabdomyolysis specifically between the high-intensity statins and the most common moderate-intensity statin, simvastatin, were not found to a significant degree in this review. Rather, baseline characteristics and drug-drug interactions (DDIs) appear to be more important regarding the risk of these adverse effects. Pharmacogenetic differences in statin metabolism may explain individual susceptibility, however genetic testing is not felt to be cost effective at this time. More importantly, statin choice should consider concomitant use of the many prevalent CYP3A4 inhibitors or inducers, and when present, rosuvastatin selection is recommended to reduce DDIs and risk of statin-induced adverse effects.
authors: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors: Lane B
authors: LB
authors: Benes
authors: Department of Medicine, University of Chicago, Chicago, IL, USA.
authors: Nikhil S
authors: NS
authors: Bassi
authors: Department of Medicine, Section of Cardiology, University of Chicago, Chicago, IL, USA. Electronic address: mdavidso@bsd.uchicago.edu.
authors: Michael H
authors: MH
authors: Davidson
mesh_terms: D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000145:classification / Q000493:pharmacokinetics; D006937:Hypercholesterolemia / Q000188:drug therapy*; D054539:Medication Therapy Management / Q000639:trends; D010597:Pharmacogenetics; D012206:Rhabdomyolysis / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Adverse effects; Drug–drug interactions; Pharmacogenetics; Statin