Specialized treatment helps cholesterol patients who suffer side effects from statins

Up to 15 percent of patients who take cholesterol-lowering statin medications experience muscle pain or other side effects, and many patients simply stop taking the drugs.

But a Loyola University Medical Center study has found that "statin-intolerant" patients still can significantly reduce their cholesterol by going to a lipid clinic staffed with physicians specially trained in treating cholesterol problems.

Among 22 statin-intolerant patients referred to Loyola's Lipid Clinic, total cholesterol dropped from 257 mg/dl to 198 mg/dl. LDL ("bad") cholesterol dropped from 172 mg/dl to 123 mg/dl, the study found.

By comparison, in a control group of 21 statin-intolerant patients who were not referred to a lipid clinic, total cholesterol dropped by only 3 points, and LDL cholesterol dropped by only 1 point.

"Stain intolerance can be a significant barrier to patients in meeting their cholesterol goals," said Binh An P. Phan, MD, senior author of the study. "Referring to a formal lipid clinic may be an effective strategy to help improve cholesterol treatment in this challenging population."

Findings were presented at the 2013 National Lipid Association Scientific Sessions by Taishi Hirai, MD, a co-author of the study.

Clinical trials of statins have reported low rates of side effects. But patient surveys conducted in real-world settings have found that as many as 15 percent of patients experience side effects.

The most common side effect is muscle soreness, fatigue or weakness.

At Loyola's Lipid Clinic, a cardiologist who has received advanced training in lipidology (cholesterol management) performs an in-depth evaluation of a patient's statin intolerance, and prepares an in-depth treatment regimen. Properly adjusting a patient's medication can enable the patient to continue taking statins. The physician adjusts medication by, for example, switching to a different statin or changing the dose or frequency of the drug, Phan said.

Phan is medical director of Loyola's Preventive Cardiology and Lipid Program. The program helps prevent heart attacks and other cardiac-related disorders and provides advanced treatment of cholesterol disorders.

Phan is an assistant professor in the Division of Cardiology of Loyola University Chicago Stritch School of Medicine.