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PRavastatin Versus FlUVastatin After Statin Intolerance: The PRUV-Intolerance Study With Propensity Score Matching

 Ji Woong Roh  ;  Kyeong-Hyeon Chun  ;  Moonjong Kang  ;  Chan Joo Lee  ;  Jaewon Oh  ;  Chi-Young Shim  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Sungha Park  ;  Hyuk-Jae Chang  ;  Geu-Ru Hong  ;  Young-Guk Ko  ;  Seok-Min Kang  ;  Donghoon Choi  ;  Jong-Won Ha  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Sang-Hak Lee 
 AMERICAN JOURNAL OF MEDICINE, Vol.132(11) : 1320-1326, 2019 
Journal Title
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Asian continental ancestry group ; Hydroxymethylglutaryl coA reductases ; Hypercholesterolemia ; Safety
BACKGROUND: Limited data are available on the relapse of statin intolerance after resumption of statins. We aimed to evaluate the relapse rates of statin intolerance in patients who subsequently received pravastatin or fluvastatin and to identify associated factors. METHODS: This retrospective, propensity score-matched cohort study screened data obtained from a tertiary university hospital between 2006 and 2015. Of 8073 patients screened, 488 with statin intolerance who received pravastatin or fluvastatin with regular follow-up were enrolled. After propensity score matching of patients, 384 were finally analyzed. The primary outcome variables were relapse of statin intolerance and stopping (ie, discontinuation or switching to other statins) rate for the 2 statins. RESULTS: During the median follow-up period of 37 months, the rate of relapse of intolerance was 10.4% and 18.2% among users of pravastatin and fluvastatin, respectively (P = 0.04). However, the log-rank test showed no difference in the relapse-free rates between the 2 groups (P = 0.34). The stopping rates of the 2 statins were 36.5% and 42.2% (P = 0.30), respectively, for various reasons, including low efficacy of the drugs. After adjustment, chronic kidney disease (hazard ratio [HR] 1.83, P = 0.03) and previous creatine kinase elevation (HR 3.13, P = 0.001) were identified as independent determinants of relapse. Older age (HR 1.03, P = 0.057) and female sex (HR 1.70, P = 0.059) were associated, but not significantly, with relapse. CONCLUSION: Although a small proportion of patients taking pravastatin or fluvastatin experienced a relapse of intolerance, many patients eventually discontinued or changed these agents. Chronic kidney disease and history of creatine kinase elevation were independent determinants of relapse.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chun, Kyeong Hyeon(전경현) ORCID logo https://orcid.org/0000-0002-7798-658X
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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