The National Lipid Association (NLA) has provided an updated statin intolerance definition and key consideration for ASCVD risk reduction in patients who are statin intolerant in a recently published scientific statement.

In the scientific statement from the NLA statin intolerance is defined as one or more adverse effects associated with statin therapy which resolves or improves with dose reduction or discontinuation. It can be classified as complete (inability to tolerate any dose of as statin) or partial (inability to tolerate the dose necessary to reach therapeutic objective). At least 2 statins should have been attempted, including at least one at the lowest approved daily dosage.

Non-statin therapy may be given while attempting to find a tolerable statin (dose) in order to limit the time of exposure to elevated levels of atherogenic lipoproteins in high and very high risk patients. Furthermore, non-statin therapy may be required for those who can not reach therapeutic goals with lifestyle and maximal tolerated statin therapy.

Three questions are addressed in the statement:

1. What is the new NLA definition of statin intolerance?

2. What is the prevalence of statin intolerance?

3. What is the evidence for use of non-statin therapies to lower atherogenic lipoproteins as a means of reduction adverse cardiovascular event risk?

Find this statement online at J Clin Lipidol