Evaluating Vitamin D levels and the tolerability of every-other-day statin administration in patients with previous statin intolerance

Introduction:  Statin therapy is established in the literature as an effective means of reducing stroke and cardiovascular events in patients at risk.  Statins are generally well tolerated; however some patients discontinue use due to adverse effects.  Some studies suggest that statin use, along with low Vitamin D levels, are associated with increased myalgias.

Objectives: This study will 1) assess the efficacy and tolerability of every other day statin dosing in patients with previous statin intolerance, and 2) evaluate patient vitamin D levels in instance of statin intolerance.

Study Design: Retrospective chart review of Veterans prescribed a statin with intermittent administration between January 2010 and July 2015 at Veterans Health Care System of the Ozarks. 

Methods: Veterans with intermittent statin prescriptions were included if they were between 18 to 89 years of age and had lipid panels records before and after starting therapy.  Efficacy of statin therapy was measured by change in plasma LDL-C; tolerability was measured by the percentage of patients who continue therapy six months.  Vitamin D levels were assessed in patients who discontinued therapy.

Results: Preliminary data shows intermittent dosed statins were prescribed to 199 unique patients during the study period.  The most commonly prescribed statin and dose was atorvastatin 40-80 mg every other day.  The statin was discontinued in 135 Veterans (68%), of whom 64% had Vitamin D levels available.

Conclusions: Preliminary results shows that more than half of the intermittent statin prescriptions were subsequently discontinued.  Reasons for discontinuation and any association with low vitamin D levels have not been yet been identified. Data collection and analysis will be completed March 15, 2016.