Abstract 531: Is Earlier Hepatitis A Associated with Abnormal Hepatic Response to Statin Therapy?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Helmut Sinzinger ◽  
Simona Marchesi ◽  
Graziana Lupattelli
Keyword(s):  
Side Effects ◽  
Alcohol Abuse ◽  
Statin Therapy ◽  
Hepatic Steatosis ◽  
Hepatitis A ◽  
Hepatic Enzyme ◽  
Steatosis Hepatis ◽  
Enzyme Elevation ◽  
Drug Free ◽  
Statin Response

Hepatic enzyme elevation is low (< 3%) in large statin trials. Elevations are reversible after dose reduction or statin withdrawal. Very rare cases of hepatitis have been reported. No data are available how predisposing risk factors /diseases might influence hepatic statin response. Among the patients suffering from hepatic side effects during statin therapy 896 (477 m, 419 f; aged 31–76 years) admitted with (one or more) elevated hepatic enzyme, anamnestic data on hepatitis A, B, C, hepatic steatosis, alcohol abuse, hepatobiliary problems, abnormal enzymes (GOT, GPT, γGT) were assessed. The prevalence (% vs. % statin use in Austria) was for lovastatin n= 4; 0,2 (0,7), fluvastatin n = 111; 12,4 (14,0), simvastatin n = 297; 33,1 (34,8), pravastatin n = 82; 9,2 (11,8), rosuvastatin n = 69; 7,9 (1,5), atorvastatin n = 333; 37,2 (37,2). Only 41 patients (4,27%) had concomitant muscle complaints (21 cramps, 16 aches, 3 stiffness, 1 weakness), 12 (1,33%) CK elevation, 261 (29,13%) elevated isoprostane 8epiPGF 2α . Those with muscle complaints had normal CK levels and vice versa. Pretherapeutic findings (more than one possible) were hepatitis A 326 (36,4% !!), hepatitis B 7 (0,8%), hepatitis C 3 (0,3%), hepatic steatosis 141 (15,7%), alcohol abuse 104 (11,6%) and /or hepatobiliary problems 17 (1,9%). Abnormal enzymes GOT 116 (12,9%), GPT 113 (12,6%), γGT 147 (16,4%) persisted for < 1 week. Patients after hepatitis A had significantly (p < 0,001) higher transaminases as compared to the other patients. Withdrawal of the respective statin normalized transaminases within 4 weeks in 129 patients (14,4%), in only 7 elevation persisted for a longer period (up to 7 months). After 1 year all were in the normal range. Transaminase levels due to steatosis hepatis even sometimes showed improvement after statin therapy (mean: −12,7% GOT; −14,1 GPT; −16,0 γGT). Reexposure to another statin compound after a 4 weeks drug free interval caused recurrence of side effects in 87 patients (49 with earlier hepatitis A = 56,3%). Hepatitis A seems to represent a high risk for abnormal liver function response on statin therapy and reexposure to other compounds of this family. The combination of abnormal hepatic response with muscle complaints is very rare.

Hepatic enzyme induction patterns and phenothiazine side effects

1983 ◽  
Vol 34 (4) ◽  
pp. 533-538 ◽  
Author(s):  
Jesse H Wright ◽  
Sarah B Whitaker ◽  
Cynthia B Welch ◽  
David N Teller
Keyword(s):  
Side Effects ◽  
Enzyme Induction ◽  
Hepatic Enzyme

Discontinuation of statin therapy due to muscular side effects: A survey in real life

2013 ◽  
Vol 23 (9) ◽  
pp. 871-875 ◽  
Author(s):  
D. Rosenbaum ◽  
J. Dallongeville ◽  
P. Sabouret ◽  
E. Bruckert
Keyword(s):  
Side Effects ◽  
Statin Therapy ◽  
Real Life

scholarly journals An insight into statin use and its association with muscular side effects in clinical practice

2015 ◽  
Vol 53 (2) ◽  
pp. 153-160 ◽  
Author(s):  
Andreea Farcas ◽  
Camelia Bucsa ◽  
D. Leucuta ◽  
Cristina Mogosan ◽  
M. Bojita ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Side Effects ◽  
Statin Therapy ◽  
Prospective Observational Study ◽  
Muscle Power ◽  
Statin Treatment ◽  
Lower Limbs ◽  
Time To Onset ◽  
Insight Into ◽  
Statin Use

Abstract Background. Muscular complaints are known side-effects of statin therapy, ranging from myalgia to clinically important myositis and rhabdomyolysis. We investigated the statin use and association with the presence and characteristics of muscular complaints. Methods. We conducted a prospective observational study in internal medicine departments. Patients with statin therapy before hospitalization were interviewed for muscular complaints. When muscular complaints were reported, information on type and severity of muscular symptoms, location and time to onset was collected. Results. We identified 85 patients with statin treatment at hospital admission out of 521 included. Nine (10.59%) patients reported muscular complaints associated with statin therapy. A cluster of symptoms (cramps, stiffness, decreased muscle power) was reported, affecting both upper and lower limbs. The severity of pain was in most of the cases moderate or severe. All patients reported that pain was intermittent. Five reported that pain was generalized. Symptoms appeared in the first month of treatment or three months after the drug initiation. Creatine kinase was raised in one patient. In two cases drug interactions were probably responsible for muscular complaints. Conclusion. In the studied set of patients muscular symptoms were a rather frequent effect of statin therapy. As this side-effect could be troublesome for patients and could lead to more severe outcomes, their timely detection and management is important.

A Comparison of the Short-Term Effects of Ibuprofen and Diclofenac in Spondylosis

1978 ◽  
Vol 6 (5) ◽  
pp. 369-374 ◽  
Author(s):  
W Siegmeth ◽  
W Sieberer
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Active Drug ◽  
Short Term ◽  
Forward Flexion ◽  
Parallel Group ◽  
Pain At Rest ◽  
Drug Free ◽  
Single Blind ◽  
Spinal Flexion

In this controlled, single-blind parallel group study, the effect of ibuprofen 1200 mg daily was compared with diclofenac 75 mg daily. Thirty patients entered the study, randomized into two groups, each group receiving one tablet three times daily for two weeks. A one-week wash-out period (i.e. a drug-free period during which only physiotherapy was given), preceded and followed the treatment on active drug. Assessments were made by the same clinician throughout who was unaware of the treatment of individual patients. Statistically significant improvement was shown by patients receiving ibuprofen for the degree of pain relief at rest and improvement was also shown for the degree of pain at rest and during exercise, for pain relief during exercise and for spinal flexion. Patients who received diclofenac showed stastistically significant improvement for forward flexion, together with improvement for the degree of pain on exercise. Side-effects were very few.

scholarly journals NEPHROTOXICITY ATTRIBUTED TO MEGLUMINE ANTIMONIATE (GLUCANTIME) IN THE TREATMENT OF GENERALIZED CUTANEOUS LEISHMANIASIS

1999 ◽  
Vol 41 (1) ◽  
pp. 33-37 ◽  
Author(s):  
M.L.O. RODRIGUES ◽  
R.S. COSTA ◽  
C.S. SOUZA ◽  
N.T. FOSS ◽  
A.M.F. ROSELINO
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Side Effects ◽  
Serum Creatinine ◽  
Cutaneous Leishmaniasis ◽  
Urine Osmolarity ◽  
Hepatic Enzyme ◽  
Meglumine Antimoniate ◽  
Tubular Necrosis ◽  
Electrocardiographic Abnormalities

Background: Pentavalent antimonials have became of basic importance for the treatment of leishmaniasis. Their most severe side effects have been reported to be increased hepatic enzyme levels and electrocardiographic abnormalities. Nephrotoxicity has been rarely related. Observations: We report a case of generalized cutaneous leishmaniasis involving a 50-year old male patient who was submitted to treatment with meglumine antimoniate (Glucantime). He developed acute renal failure (ARF) due to acute tubular necrosis (ATN), followed by death after receiving a total of 53 ampoules of Glucantime. Conclusions: The treatment with Glucantime was responsible by ARF diagnosed in this patient. The previous urine osmolarity and serum creatinine levels were normal and the autopsy showed ATN. It should be pointed out if ARF may also be explained by massive deposits of immunocomplexes by leishmania antibodies and antigens due to the antigenic break by the antimonial compound, since our patient presented countless lesions covering the entire tegument, similar to the Hexheimer phenomenon, but at the autopsy no glomerular alterations were seen.

Long term recombinant interferon alpha treatment in MS with special emphasis to side effects

1996 ◽  
Vol 1 (6) ◽  
pp. 366-371 ◽  
Author(s):  
Luca Durelli ◽  
MR Bongioanni ◽  
B Ferrero ◽  
D Imperiale ◽  
E Verdun ◽  
...  
Keyword(s):  
Side Effects ◽  
Interferon Alpha ◽  
Drug Efficacy ◽  
Fold Increase ◽  
Recombinant Interferon ◽  
Chronic Therapy ◽  
Stopping Treatment ◽  
Enzyme Elevation ◽  
Recombinant Interferon Alpha

Twenty relapsing-remitting (RR) clinically definite MS patients were treated with 9 MIU intramuscular recombinant interferon alpha-2a (rIFNA) (Rof eron-A, Roche) (n=12) or placebo (n=8) every other day for 6 months and followed up for a further 6 months after stopping treatment Numbers of active lesions at MRI and of patients with clinical-MRI signs of disease activity and lymphocyte interferon gamma production, which were decreased during treatment, returned to values similar to baseline and placebos after stopping treatment rIFNA chronic therapy seems therefore needed in order to maintain drug efficacy. Side effect prof ile was monitored, too, for over 1 year in the same 20 patients plus 25 additional RR MS patients. Besides the typical side effects of type 1 interferon therapy (fever, fatigue, depression, lymphopenia, hepatic enzyme elevation), occurrence of serum autoAbs was noted in 30% patients (in 60% antinuclear and in 80% antithyroid autoAbs). In two patients rIFNA treatment was stopped, in one case for antithyroid autoAbs and hypothyroidism, in the other for antinuclear autoAbs and a five-fold increase of ALT. A careful monitoring of serum autoAbs and of signs of thyroid or liver damage must always precede and accompany longterm type 1 IFN therapy.

scholarly journals Cardiovascular outcomes trials with statins in diabetes

2018 ◽  
Vol 18 (1) ◽  
pp. 7-13 ◽  
Author(s):  
Fariha Naeem ◽  
Gerard McKay ◽  
Miles Fisher
Keyword(s):  
Cardiovascular Disease ◽  
Side Effects ◽  
Primary Prevention ◽  
Secondary Prevention ◽  
Statin Therapy ◽  
Cardiovascular Events ◽  
Atherosclerotic Disease ◽  
Lipid Lowering ◽  
High Dose ◽  
Drug Side Effects

Treatment with statins is one of the most effective ways of reducing cardiovascular events in those with diabetes. Many studies containing thousands of subjects with diabetes have demonstrated that statins reduce cardiovascular events when there is no known cardiovascular disease (primary prevention) and in those with confirmed atherosclerotic disease (secondary prevention). High-dose statins appear to be even more effective in established cardiovascular disease, but at the expense of increased drug side effects. In this paper we review the evidence for the benefits of statins in diabetes. In a second review we will examine the evidence for possible benefits of other lipid-lowering therapies when these are added to background statin therapy in diabetes.

scholarly journals Statin Use and Its Effects on Skeletal Related Events in Patients with Multiple Myeloma

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5774-5774 ◽  
Author(s):  
Fernando M Vargas Madueno ◽  
Amin Benyounes ◽  
Gentry King ◽  
Kuan-Hsiang Gary Huang ◽  
Gabor Varadi
Keyword(s):  
Multiple Myeloma ◽  
Vitamin D ◽  
Alcohol Abuse ◽  
Statin Therapy ◽  
Paget’S Disease ◽  
Paget's Disease ◽  
Exact Test ◽  
History Of ◽  
Skeletal Related Events ◽  
Statin Use

Abstract Introduction: Skeletal related events (SRE) in multiple myeloma (MM) patients are associated with significant morbidity and mortality. Studies assessing the anti myeloma effect of statins in conjunction with chemotherapy have shown conflicting results with regards to overall survival or disease response. To our knowledge there have been no studies evaluating the effect of statins on SRE. Here we sought to assess the relationship between statin use and the presence of SRE. Methods: We retrospectively reviewed 101 patients seen at our institution between the years 2007-2012 who had a diagnosis of MM separating them in 2 groups, patients on statin therapy (n=50) and those without statin therapy (n=51). Statin use was considered if present prior to the occurrence of a SRE. SRE were defined as pathologic fractures, necessity for orthopedic intervention, radiation therapy or spinal cord compression. MM stage as per the International Staging System (ISS), as well as history of osteoporosis, malignancy, hypothyroidism, Paget's disease of the bone, alcohol abuse, smoking status, calcium-vitamin D, and bisphosphonate use were also recorded. Results: In our cohorts the prevalence of SRE was significantly lower in patients on statin medication when compared to statin naive patients, (36% vs. 58.8% respectively, p = 0.029, Fisher's exact test, Figure 1). No significant differences were noted between statin treated group and statin naive group in the following variable subgroups (Fisher's exact test): the history of smoking or alcohol abuse, the documented diagnosis of osteoporosis, coexistent malignancy, hypothyroidism, or Paget's disease of the bone, and the use of other medications including bisphosphonates or calcium - vitamin D supplementation. There were no significant differences in distribution of cancer staging (according to ISS) when we compared between statin use status (chi-square test for trend). Conclusion: The use of statins was associated with a decrease in the prevalence of SRE in patients with MM. This was found independent of disease stage, history of osteoporosis or second malignancy, and bisphosphonate use. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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