PRavastatin Versus FlUVastatin After Statin Intolerance: The PRUV-Intolerance Study With Propensity Score Matching

Ji Woong Roh, Kyeong Hyeon Chun, Moonjong Kang, Chan Joo Lee, Jaewon Oh, Chi Young Shim, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Sungha Park, Hyuk Jae Chang, Geu Ru Hong, Young Guk Ko, Seok Min Kang, Donghoon Choi, Jong Won Ha, Myeong Ki Hong, Yangsoo Jang, Sang Hak Lee

Research output: Contribution to journalArticle

Abstract

Background: Limited data are available on the relapse of statin intolerance after resumption of statins. We aimed to evaluate the relapse rates of statin intolerance in patients who subsequently received pravastatin or fluvastatin and to identify associated factors. Methods: This retrospective, propensity score-matched cohort study screened data obtained from a tertiary university hospital between 2006 and 2015. Of 8073 patients screened, 488 with statin intolerance who received pravastatin or fluvastatin with regular follow-up were enrolled. After propensity score matching of patients, 384 were finally analyzed. The primary outcome variables were relapse of statin intolerance and stopping (ie, discontinuation or switching to other statins) rate for the 2 statins. Results: During the median follow-up period of 37 months, the rate of relapse of intolerance was 10.4% and 18.2% among users of pravastatin and fluvastatin, respectively (P = 0.04). However, the log-rank test showed no difference in the relapse-free rates between the 2 groups (P = 0.34). The stopping rates of the 2 statins were 36.5% and 42.2% (P = 0.30), respectively, for various reasons, including low efficacy of the drugs. After adjustment, chronic kidney disease (hazard ratio [HR] 1.83, P = 0.03) and previous creatine kinase elevation (HR 3.13, P = 0.001) were identified as independent determinants of relapse. Older age (HR 1.03, P = 0.057) and female sex (HR 1.70, P = 0.059) were associated, but not significantly, with relapse. Conclusion: Although a small proportion of patients taking pravastatin or fluvastatin experienced a relapse of intolerance, many patients eventually discontinued or changed these agents. Chronic kidney disease and history of creatine kinase elevation were independent determinants of relapse.

Original languageEnglish
Pages (from-to)1320-1326.e1
JournalAmerican Journal of Medicine
Volume132
Issue number11
DOIs
Publication statusPublished - 2019 Nov

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fluvastatin
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pravastatin
Propensity Score
Recurrence
Creatine Kinase
Chronic Renal Insufficiency
Sex Ratio

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Roh, Ji Woong ; Chun, Kyeong Hyeon ; Kang, Moonjong ; Lee, Chan Joo ; Oh, Jaewon ; Shim, Chi Young ; Ahn, Chul Min ; Kim, Jung Sun ; Kim, Byeong Keuk ; Park, Sungha ; Chang, Hyuk Jae ; Hong, Geu Ru ; Ko, Young Guk ; Kang, Seok Min ; Choi, Donghoon ; Ha, Jong Won ; Hong, Myeong Ki ; Jang, Yangsoo ; Lee, Sang Hak. / PRavastatin Versus FlUVastatin After Statin Intolerance : The PRUV-Intolerance Study With Propensity Score Matching. In: American Journal of Medicine. 2019 ; Vol. 132, No. 11. pp. 1320-1326.e1.
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title = "PRavastatin Versus FlUVastatin After Statin Intolerance: The PRUV-Intolerance Study With Propensity Score Matching",
abstract = "Background: Limited data are available on the relapse of statin intolerance after resumption of statins. We aimed to evaluate the relapse rates of statin intolerance in patients who subsequently received pravastatin or fluvastatin and to identify associated factors. Methods: This retrospective, propensity score-matched cohort study screened data obtained from a tertiary university hospital between 2006 and 2015. Of 8073 patients screened, 488 with statin intolerance who received pravastatin or fluvastatin with regular follow-up were enrolled. After propensity score matching of patients, 384 were finally analyzed. The primary outcome variables were relapse of statin intolerance and stopping (ie, discontinuation or switching to other statins) rate for the 2 statins. Results: During the median follow-up period of 37 months, the rate of relapse of intolerance was 10.4{\%} and 18.2{\%} among users of pravastatin and fluvastatin, respectively (P = 0.04). However, the log-rank test showed no difference in the relapse-free rates between the 2 groups (P = 0.34). The stopping rates of the 2 statins were 36.5{\%} and 42.2{\%} (P = 0.30), respectively, for various reasons, including low efficacy of the drugs. After adjustment, chronic kidney disease (hazard ratio [HR] 1.83, P = 0.03) and previous creatine kinase elevation (HR 3.13, P = 0.001) were identified as independent determinants of relapse. Older age (HR 1.03, P = 0.057) and female sex (HR 1.70, P = 0.059) were associated, but not significantly, with relapse. Conclusion: Although a small proportion of patients taking pravastatin or fluvastatin experienced a relapse of intolerance, many patients eventually discontinued or changed these agents. Chronic kidney disease and history of creatine kinase elevation were independent determinants of relapse.",
author = "Roh, {Ji Woong} and Chun, {Kyeong Hyeon} and Moonjong Kang and Lee, {Chan Joo} and Jaewon Oh and Shim, {Chi Young} and Ahn, {Chul Min} and Kim, {Jung Sun} and Kim, {Byeong Keuk} and Sungha Park and Chang, {Hyuk Jae} and Hong, {Geu Ru} and Ko, {Young Guk} and Kang, {Seok Min} and Donghoon Choi and Ha, {Jong Won} and Hong, {Myeong Ki} and Yangsoo Jang and Lee, {Sang Hak}",
year = "2019",
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language = "English",
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pages = "1320--1326.e1",
journal = "American Journal of Medicine",
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Roh, JW, Chun, KH, Kang, M, Lee, CJ, Oh, J, Shim, CY, Ahn, CM, Kim, JS, Kim, BK, Park, S, Chang, HJ, Hong, GR, Ko, YG, Kang, SM, Choi, D, Ha, JW, Hong, MK, Jang, Y & Lee, SH 2019, 'PRavastatin Versus FlUVastatin After Statin Intolerance: The PRUV-Intolerance Study With Propensity Score Matching', American Journal of Medicine, vol. 132, no. 11, pp. 1320-1326.e1. https://doi.org/10.1016/j.amjmed.2019.06.003

PRavastatin Versus FlUVastatin After Statin Intolerance : The PRUV-Intolerance Study With Propensity Score Matching. / Roh, Ji Woong; Chun, Kyeong Hyeon; Kang, Moonjong; Lee, Chan Joo; Oh, Jaewon; Shim, Chi Young; Ahn, Chul Min; Kim, Jung Sun; Kim, Byeong Keuk; Park, Sungha; Chang, Hyuk Jae; Hong, Geu Ru; Ko, Young Guk; Kang, Seok Min; Choi, Donghoon; Ha, Jong Won; Hong, Myeong Ki; Jang, Yangsoo; Lee, Sang Hak.

In: American Journal of Medicine, Vol. 132, No. 11, 11.2019, p. 1320-1326.e1.

Research output: Contribution to journalArticle

TY - JOUR

T1 - PRavastatin Versus FlUVastatin After Statin Intolerance

T2 - The PRUV-Intolerance Study With Propensity Score Matching

AU - Roh, Ji Woong

AU - Chun, Kyeong Hyeon

AU - Kang, Moonjong

AU - Lee, Chan Joo

AU - Oh, Jaewon

AU - Shim, Chi Young

AU - Ahn, Chul Min

AU - Kim, Jung Sun

AU - Kim, Byeong Keuk

AU - Park, Sungha

AU - Chang, Hyuk Jae

AU - Hong, Geu Ru

AU - Ko, Young Guk

AU - Kang, Seok Min

AU - Choi, Donghoon

AU - Ha, Jong Won

AU - Hong, Myeong Ki

AU - Jang, Yangsoo

AU - Lee, Sang Hak

PY - 2019/11

Y1 - 2019/11

N2 - Background: Limited data are available on the relapse of statin intolerance after resumption of statins. We aimed to evaluate the relapse rates of statin intolerance in patients who subsequently received pravastatin or fluvastatin and to identify associated factors. Methods: This retrospective, propensity score-matched cohort study screened data obtained from a tertiary university hospital between 2006 and 2015. Of 8073 patients screened, 488 with statin intolerance who received pravastatin or fluvastatin with regular follow-up were enrolled. After propensity score matching of patients, 384 were finally analyzed. The primary outcome variables were relapse of statin intolerance and stopping (ie, discontinuation or switching to other statins) rate for the 2 statins. Results: During the median follow-up period of 37 months, the rate of relapse of intolerance was 10.4% and 18.2% among users of pravastatin and fluvastatin, respectively (P = 0.04). However, the log-rank test showed no difference in the relapse-free rates between the 2 groups (P = 0.34). The stopping rates of the 2 statins were 36.5% and 42.2% (P = 0.30), respectively, for various reasons, including low efficacy of the drugs. After adjustment, chronic kidney disease (hazard ratio [HR] 1.83, P = 0.03) and previous creatine kinase elevation (HR 3.13, P = 0.001) were identified as independent determinants of relapse. Older age (HR 1.03, P = 0.057) and female sex (HR 1.70, P = 0.059) were associated, but not significantly, with relapse. Conclusion: Although a small proportion of patients taking pravastatin or fluvastatin experienced a relapse of intolerance, many patients eventually discontinued or changed these agents. Chronic kidney disease and history of creatine kinase elevation were independent determinants of relapse.

AB - Background: Limited data are available on the relapse of statin intolerance after resumption of statins. We aimed to evaluate the relapse rates of statin intolerance in patients who subsequently received pravastatin or fluvastatin and to identify associated factors. Methods: This retrospective, propensity score-matched cohort study screened data obtained from a tertiary university hospital between 2006 and 2015. Of 8073 patients screened, 488 with statin intolerance who received pravastatin or fluvastatin with regular follow-up were enrolled. After propensity score matching of patients, 384 were finally analyzed. The primary outcome variables were relapse of statin intolerance and stopping (ie, discontinuation or switching to other statins) rate for the 2 statins. Results: During the median follow-up period of 37 months, the rate of relapse of intolerance was 10.4% and 18.2% among users of pravastatin and fluvastatin, respectively (P = 0.04). However, the log-rank test showed no difference in the relapse-free rates between the 2 groups (P = 0.34). The stopping rates of the 2 statins were 36.5% and 42.2% (P = 0.30), respectively, for various reasons, including low efficacy of the drugs. After adjustment, chronic kidney disease (hazard ratio [HR] 1.83, P = 0.03) and previous creatine kinase elevation (HR 3.13, P = 0.001) were identified as independent determinants of relapse. Older age (HR 1.03, P = 0.057) and female sex (HR 1.70, P = 0.059) were associated, but not significantly, with relapse. Conclusion: Although a small proportion of patients taking pravastatin or fluvastatin experienced a relapse of intolerance, many patients eventually discontinued or changed these agents. Chronic kidney disease and history of creatine kinase elevation were independent determinants of relapse.

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DO - 10.1016/j.amjmed.2019.06.003

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