Can Restoring Vit D Levels Improve Adherence in Statin Rechallenge?
For patients with statin-induced myopathy, restoring low vitamin D levels appeared to be help improve medication adherence and ultimately prevent cardiovascular and mortality events, according to a study published in the Journal of Pharmacy Practice.
Statins are a class of drugs used to decrease cholesterol levels and reduce risks for coronary heart disease. One of the primary reasons for nonadherence, however, is the muscular adverse effects associated with these agents.
A team of pharmacists from the Veterans Affairs Loma Linda Healthcare System, Loma Linda, CA, evaluated the effect of replenishing vitamin D levels on statin-induced myopathy in a study of veteran patients who were not able to maintain statin therapy in a pharmacist-run ambulatory care setting. The study's primary outcome was the percentage of patients who maintained statin therapy at 12 months after reinitiation; secondary objectives included change in patients' vitamin D levels, fasting lipid profiles, and achievement of lipid goals after restarting statin therapy.
The retrospective cohort study included patients with low-serum vitamin D, history of statin-induced myopathy, and those who received vitamin D replenishment prior to rechallenging statin therapy between December 1, 2008 and April 1, 2015; a total of 27 patients met the study criteria.
The data showed all patients were able to maintain their statin therapy after receiving vitamin D supplementation with no reports of myalgia. About 40% of patients were able to tolerate their previously failed statin therapy. The most commonly reinitiated statins were atorvastatin, pravastatin, and rosuvastatin. By the 12-month follow-up, study authors noted a 22–30% increase in the number of patients who met the cholesterol goals according to the national lipid guidelines.
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