Safety and tolerability of statins
September 1, 2013
Overall statin safety and tolerability was the focus of a recent (non-company sponsored) meta-analyses of more than 135 trials involving nearly 250,000 individuals. Statin therapy was no different from control with regard to myalgia, creatine kinase elevation, cancer, or discontinuation due to adverse events. There was a higher incidence of diabetes associated with statin use (odds ratio [OR], 1.09; 95% CI, 1.02-1.16). Transaminases were also elevated more commonly (OR, 1.51; 95% CI, 1.24-1.84). The safest statins appeared to be simvastatin and pravastatin. When similar doses were compared, there were higher discontinuation rates with atorvastatin and rosuvastatin. The highest dose (80 mg) of simvastatin was associated with a significantly increased risk of creatine kinase elevation (OR, 4.14; 95% CI, 1.08-16.24). The authors conclude that statins, as a class, are well tolerated, except for a higher risk of diabetes. Simvastatin and pravastatin seem to be more tolerable than other statins (Circ Cardiovasc Qual Outcomes published online July 9, 2013. DOI: 10.1161/CIRCOUTCOMES.111.000071).
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