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 language | English |
|---|---|
| Pages (from-to) | 1320-1326.e1 |
| Journal | American Journal of Medicine |
| Volume | 132 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - 2019 Nov |
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All Science Journal Classification (ASJC) codes
- Medicine(all)
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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 journal › Article
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.
UR - http://www.scopus.com/inward/record.url?scp=85073170573&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073170573&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2019.06.003
DO - 10.1016/j.amjmed.2019.06.003
M3 - Article
C2 - 31278931
AN - SCOPUS:85073170573
VL - 132
SP - 1320-1326.e1
JO - American Journal of Medicine
JF - American Journal of Medicine
SN - 0002-9343
IS - 11
ER -