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Discontinuation of Statins in Routine Care Settings: A Cohort Study
Open accessAbstract
BACKGROUND: Systematic data on discontinuation of statins in routine practice of medicine are limited. OBJECTIVE: To investigate the reasons for statin discontinuation and the role of statin-related events (clinical events or symptoms believed to have been caused by statins) in routine care settings. DESIGN: A retrospective cohort study. SETTING: Practices affiliated with Brigham and Women's Hospital and Massachusetts General Hospital in Boston. PATIENTS: Adults who received a statin prescription between 1 January 2000 and 31 December 2008. MEASUREMENTS: Information on reasons for statin discontinuations was obtained from a combination of structured electronic medical record entries and analysis of electronic provider notes by validated software. RESULTS: Statins were discontinued at least temporarily for 57 292 of 107 835 patients. Statin-related events were documented for 18 778 (17.4%) patients. Of these, 11 124 had statins discontinued at least temporarily; 6579 were rechallenged with a statin over the subsequent 12 months. Most patients who were rechallenged (92.2%) were still taking a statin 12 months after the statin-related event. Among the 2721 patients who were rechallenged with the same statin to which they had a statin-related event, 1295 were receiving the same statin 12 months later, and 996 of them were receiving the same or a higher dose. LIMITATIONS: Statin discontinuations and statin-related events were assessed in practices affiliated with 2 academic medical centers. Utilization of secondary data could have led to missing or misinterpreted data. Natural-language-processing tools used to compensate for the low (30%) proportion of reasons for statin discontinuation documented in structured electronic medical record fields are not perfectly accurate. CONCLUSION: Statin-related events are commonly reported and often lead to statin discontinuation. However, most patients who are rechallenged can tolerate statins long-term. This suggests that many of the statin-related events may have other causes, are tolerable, or may be specific to individual statins rather than the entire drug class. PRIMARY FUNDING SOURCE: National Library of Medicine, Diabetes Action Research and Education Foundation, and Chinese National Key Program of Clinical Science.
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“Statin-associated muscle symptoms cover a broader range of clinical presentations, usually with normal or minimally elevated CK levels”
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“with a prevalence of 7–29% in registries and observational studies.”
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“From a treatment viewpoint, Zhang et al.14 showed that 90% of patients reporting SAMS to one statin were able to tolerate an alternative statin with continued use after 12 months”
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“suggesting that statin-attributed symptoms may have had other causes or were not generalizable to other statins.”
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Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Grundy, S. M., Becker, D. M., Clark, L. T., Cooper, R., Denke, M. A., Howard, J. L., Hunninghake, D. B., Illingworth, D. R., Luepker, R. V., McBride, P. E., et al. (2002) · Civil War Book Review · Cited by 12,198
OLSSON, A. G., McMurray, J. J. V., Thorgeirsson, G., Spaulding, C. M., Slattery, J., Pyörälà, K., Færgeman, O., Wright, R. S., Berg, K. M., Wilhelmsen, L., et al. (1994) · The Lancet · Cited by 8,467
Sacks, F. M., Pfeffer, M. A., Moye, L. A., Rouleau, J. L., Rutherford, J. D., Cole, T. G., Brown, L., Warnica, J. W., Arnold, J. M. O., Wun, C.-C., et al. (1996) · New England Journal of Medicine · doi:10.1056/nejm199610033351401 · Cited by 7,439
SCANDINAVIANSIMVASTATINSURVIVAL (1994) · The Lancet · doi:10.1016/s0140-6736(94)90566-5 · Cited by 3,638
Collaborators, C. T. T. (. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60367-5 · Cited by 2,833
The “Meaningful Use” Regulation for Electronic Health Records
Blumenthal, D., & Tavenner, M. (2010) · New England Journal of Medicine · doi:10.1056/nejmp1006114 · Cited by 2,059
Statins for the primary prevention of cardiovascular disease
Taylor, F., Huffman, M. D., Macedo, A. F., Moore, T. H., Burke, M., Davey Smith, G., Ward, K., Ebrahim, S., & Gay, H. C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004816.pub5 · Cited by 1,934
Kaufman, D. W., Kelly, J. P., Rosenberg, L., Anderson, T. E., & Mitchell, A. A. (2002) · JAMA · doi:10.1001/jama.287.3.337 · Cited by 1,845
Jones, P. H., Davidson, M. H., Stein, E. A., Bays, H. E., McKenney, J. M., Miller, E., Cain, V. A., & Blasetto, J. W. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00530-7 · Cited by 1,392
Long-term persistence in use of statin therapy in elderly patients
Benner, J. S. (2002) · JAMA · doi:10.1001/jama.288.4.455 · Cited by 1,232
Bruckert, E., Hayem, G., Dejager, S., Yau, C., & Bégaud, B. (2005) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-005-5686-z · Cited by 1,226
ACC/AHA/NHLBI Clinical Advisory on the Use and Safety of Statins
Writing Committee Members:, Pasternak, R. C., Smith, S. C., Bairey-Merz, C. N., Grundy, S. M., Cleeman, J. I., & Lenfant, C. (2002) · Circulation · doi:10.1161/01.cir.0000032466.44170.44 · Cited by 1,088
Adherence with statin therapy in elderly patients with and without acute coronary syndromes
Jackevicius, C. A. (2002) · JAMA · doi:10.1001/jama.288.4.462 · Cited by 1,077
Rasmussen, J. N., Chong, A., & Alter, D. A. (2007) · JAMA · doi:10.1001/jama.297.2.177 · Cited by 975
The Post Coronary Artery Bypass Graft Trial Investigators (1997) · New England Journal of Medicine · doi:10.1056/nejm199701163360301 · Cited by 969
The safety of statins in clinical practice
Armitage, J. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60716-8 · Cited by 833
Statin Safety: A Systematic Review
Law, M., & Rudnicka, A. R. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.12.010 · Cited by 808
Persistence of Use of Lipid-Lowering Medications
Avorn, J., Monette, J., Lacour, A. S., Bohn, R. L., Monane, M., Mogun, H., & LeLorier, J. (1998) · JAMA · doi:10.1001/jama.279.18.1458 · Cited by 635
Ho, P. M., Magid, D. J., Shetterly, S. M., Olson, K. L., Maddox, T. M., Peterson, P. N., Masoudi, F. A., & Rumsfeld, J. S. (2008) · American Heart Journal · doi:10.1016/j.ahj.2007.12.011 · Cited by 587
Withdrawal of Statins Increases Event Rates in Patients With Acute Coronary Syndromes
Heeschen, C., Hamm, C. W., Laufs, U., Snapinn, S. M., Böhm, M., & White, H. D. (2002) · Circulation · doi:10.1161/01.cir.0000012530.68333.c8 · Cited by 478
Risks Associated With Statin Therapy: A Systematic Overview of Randomized Clinical Trials
Kashani, A., Phillips, C. O., Foody, J. M., Wang, Y., Mangalmurti, S., Ko, D. T., & Krumholz, H. M. (2006) · Circulation · doi:10.1161/circulationaha.106.624890 · Cited by 474
Unlocking Clinical Data from Narrative Reports: A Study of Natural Language Processing
Hripcsak, G. M., Friedman, C., Alderson, P. O., DuMouchel, W., Johnson, S. B., & Clayton, P. D. (1995) · Annals of Internal Medicine · doi:10.7326/0003-4819-122-9-199505010-00007 · Cited by 340
Suboptimal statin adherence and discontinuation in primary and secondary prevention populations
Ellis, J. J., Erickson, S. R., Stevenson, J. G., Bernstein, S. J., Stiles, R. A., & Fendrick, A. M. (2004) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2004.30516.x · Cited by 320
Statins for the primary prevention of cardiovascular disease
Taylor, F. C., Ward, K. J., Moore, T. H., Burke, M., Smith, G. D., Casas, J. P., & Ebrahim, S. B. J. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004816.pub4 · Cited by 315
Li, W., Wang, J., Thompson, P., Wong, S., Struthers, A. D., & MacDonald, T. M. (2002) · Heart · doi:10.1136/heart.88.3.229 · Cited by 293
Outcomes in 45 Patients With Statin-Associated Myopathy
Hansen, K. E., Hildebrand, J. P., Ferguson, E. E., & Stein, J. H. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.22.2671 · Cited by 280
ACC/AHA/NHLBI Clinical Advisory on the Use and Safety of Statins
Pasternak, R. C., Smith, S. C., Merz, C. N. B., Grundy, S. M., Cleeman, J. I., & Lenfant, C. J. M. (2002) · Stroke · doi:10.1161/01.str.0000034125.94759.41 · Cited by 257
Statin myopathy: A common dilemma not reflected in clinical trials
Fernandez, G., Spatz, E. S., Jablecki, C. K., & Phillips, P. S. (2011) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.78a.10073 · Cited by 217
Brown, A. S., Bakker-Arkema, R. G., Yellen, L. G., et al. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00300-3 · Cited by 181
Trends in hypercholesterolemia, treatment and control among United States adults.
Ford, E., Li, C.-Y., Pearson, W., Zhao, G.-X., & Mokdad, A. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2008.11.033 · Cited by 166
Prevalence of Musculoskeletal Pain and Statin Use
Buettner, C., Davis, R. B., Leveille, S. G., Mittleman, M. A., & Mukamal, K. J. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0636-7 · Cited by 159
Zaninotto, P., Head, J. A., Stamatakis, E. A., Wardle, H., & Mindell, J. S. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2008.077305 · Cited by 151
Backes, J. M., Venero, C. V., Gibson, C., Ruisinger, J. F., Howard, P. A., Thompson, P. D., & Moriarty, P. M. (2008) · Annals of Pharmacotherapy · doi:10.1345/aph.1k604 · Cited by 127
Factors Related to Adherence to Statin Therapy
McGinnis, B., Olson, K. L., Magid, D. J., Bayliss, E., Korner, E. J., Brand, D. W., & Steiner, J. F. (2007) · Annals of Pharmacotherapy · doi:10.1345/aph.1k209 · Cited by 121
Statin Discontinuation in High-Risk Patients: A Systematic Review of the Evidence
Sandoval, Y.-H. G., Braganza, M. V., & Daskalopoulou, S. S. (2011) · Current Pharmaceutical Design · doi:10.2174/138161211798220891 · Cited by 85
Patients' Perspectives on Nonadherence to Statin Therapy: A Focus-Group Study
Fung, V., Sinclair, F., Wang, H., Dailey, D., Hsu, J., & Shaber, R. E. (2010) · The Permanente Journal · doi:10.7812/tpp/09-090 · Cited by 83
Needed: Pragmatic Clinical Trials for Statin-Intolerant Patients
Maningat, P. D., & Breslow, J. L. (2011) · New England Journal of Medicine · doi:10.1056/nejmp1112023 · Cited by 74
Glueck, C. J., Aregawi, D., Agloria, M., Khalil, Q., Winiarska, M., Munjal, J., Gogineni, S., & Wang, P. (2006) · Clinical Therapeutics · doi:10.1016/j.clinthera.2006.06.004 · Cited by 73
Athyros, V. G., Τζιόμαλος, Κ., Kakafika, A. I., Koumaras, H., Karagiannis, A. I., & Mikhailidis, D. P. (2007) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2007.09.096 · Cited by 71
Treating statin-intolerant patients
Arca, M., & Pigna (2011) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s11244 · Cited by 69
Once-a-Week Rosuvastatin (2.5 to 20 mg) in Patients With a Previous Statin Intolerance
Ruisinger, J. F., Backes, J. M., Gibson, C., & Moriarty, P. M. (2008) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2008.09.095 · Cited by 67
Exploring Patients' Reasons for Discontinuance of Heart Medications
Garavalia, L. S., Garavalia, B., Spertus, J. A., & Decker, C. (2009) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0b013e3181ae7b2a · Cited by 64
Statin discontinuation: an underestimated risk?
Τζιόμαλος, Κ., Athyros, V. G., & Mikhailidis, D. P. (2008) · Current Medical Research and Opinion · doi:10.1185/03007990802469102 · Cited by 42
Skentzos, S. C., Shubina, M., Plutzky, J., & Turchin, A. (2011) · PubMed Central · Cited by 31
Self-citationeQuality for all: Extending automated quality measurement of free text clinical narratives.
Brown, S. H., Elkin, P. L., Rosenbloom, S. T., et al. (2008) · PubMed · Cited by 24
Managing statin-induced muscle toxicity in a lipid clinic
Blaier, O., Lishner, M., & Elis, A. (2011) · Journal of Clinical Pharmacy and Therapeutics · doi:10.1111/j.1365-2710.2011.01254.x · Cited by 14
Research works printed but not linked: 4
- Taylor F, 2011, Cochrane Database Syst Rev, CD004816
- 1994, Lancet, 344, 1383
- Skentzos S, 2011, AMIA Annu Symp Proc, 2011, 1270
- Brown SH, 2008, AMIA Annu Symp Proc, 71
Cited by
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Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000625 · Cited by 6,185
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.003 · Cited by 2,691
Interpretation of the evidence for the efficacy and safety of statin therapy
Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G. D., DeMets, D., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31357-5 · Cited by 1,857
Stroes, E. S., Thompson, P. D., Corsini, A., Vladutiu, G. D., Raal, F. J., Ray, K. K., Roden, M., Stein, E., Tokgözoğlu, L., Nordestgaard, B. G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv043 · Cited by 1,443
Inclisiran in Patients at High Cardiovascular Risk with Elevated LDL Cholesterol
Ray, K. K., Landmesser, U., Leiter, L. A., Kallend, D., Dufour, R., Karakas, M., Hall, T., Troquay, R. P. T., Turner, T., Visseren, F. L. J., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1615758 · Cited by 992
Metadata
- Authors
- Zhang, H., Plutzky, J., Skentzos, S., Morrison, F., Mar, P., Shubina, M., & Turchin, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2013-04-02
- Volume
- 158
- Issue
- 7
- Pages
- 526-534
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- PMC
- PMC3692286
- OpenAlex
- W1998569580
- Cited by
- 548
- References
- 50
- Citations by year
- 2026: 25 · 2025: 15 · 2024: 19 · 2023: 27 · 2022: 43 · 2021: 34 · 2020: 41 · 2019: 49 · 2018: 42 · 2017: 52 · 2016: 77 · 2015: 54 · 2014: 46 · 2013: 24
- FWCI
- 65.99
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. National Library of Medicine (RC1LM010460)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- statins, statin discontinuation, statin rechallenge, drug tolerability, lipid-lowering therapy, primary care, electronic health records, natural language processing
- MeSH terms
- Documentation, Humans, Hypercholesterolemia, Natural Language Processing, Retrospective Studies, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Withholding Treatment, Electronic Health Records
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