NOTE: This release was originally published by the National Lipid Association on June 4, 2022. It has been edited for clarity and space.
Dr. Joseph Saseen, PharmD
The National Lipid Association (NLA) announced the release of its official scientific statement on Statin Intolerance: A New Definition and Key Considerations for Atherosclerotic Cardiovascular Disease (ASCVD) Risk Reduction in the Statin Intolerant Patient. Statins are a class of medications that lower cholesterol and reduce cardiovascular events and cardiovascular death in patients at risk for ASCVD. The statement provides updates on the evidence-based facts about statins and statin intolerance and makes practical recommendations to aid clinicians in determining a therapeutic objective in contemporary clinical practice.
The NLA defines statin intolerance as, “one or more adverse effects associated with statin therapy which resolve or improve with dose reduction or discontinuation and can be classified as a complete inability to tolerate any dose of a statin, or partial intolerance with inability to tolerate the dose necessary to achieve the patient-specific therapeutic objective.”
According to Joseph J. Saseen, PharmD, CLS, FNLA, President of the NLA at its time of publication, Associate Dean and Professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, and co-author on the statement, “The Scientific Statements committee did an excellent job providing a contemporary and realistic definition of Statin Intolerance, in addition to several clinically relevant recommendations. This information can further empower Lipid Specialists to provide the best care possible for patients that are challenged by the presence of statin intolerance.”
“It is important for clinicians to recognize that for a large majority of patients who experience symptoms while on a statin, a tolerable statin regimen can be identified, which may require a lower dosage, a different agent, or a different dosing schedule such as alternate days. Also, non-statin therapy may be required, alone or in combination with a statin, for those patients who are unable to achieve therapeutic objectives due to statin intolerance,” said co-author Kevin C. Maki, PhD, CLS, FNLA, President and Chief Scientist of Midwest Biomedical Research and Adjunct Professor of Indiana University School of Public Health.
“It’s been 8 years since the National Lipid Association has updated the statin intolerance definition. In that time, we have learned a lot about this clinical syndrome, began using new therapeutics, and improved the way in which we treat patients with statin intolerance. This new definition highlights that statin intolerance is not an ‘all or nothing’ picture, but rather a continuum, and that all symptoms have clinical relevance. It is important to still consider statins as the backbone of therapy, while ultimately focusing on the patient-specific therapeutic objective and lowering of atherogenic lipoproteins” added corresponding author, Mary Katherine Cheeley, PharmD, CLS, FNLA.
The manuscript, titled “Statin Intolerance: A New Definition and Key Considerations for ASCVD Risk Reduction in the Statin Intolerant Patient” is in press with the Journal of Clinical Lipidology and can be accessed through the National Lipid Association’s website.
ABOUT THE NATIONAL LIPID ASSOCIATION
The NLA is a multidisciplinary specialty society focused on prevention of cardiovascular disease and other lipid-related disorders. The NLA’s mission is to enhance the practice of lipid management in clinical medicine, and one of its goals is to enhance efforts to reduce death and disability related to disorders of lipid metabolism in patients. Members include an array of healthcare professionals, including MDs, DOs, PhD researchers, nurses, nurse practitioners, physician assistants, pharmacists, exercise physiologists, and dietitians.