The Pharmaceutical Journal
Vol 270 No 7242 p427
29 March 2003

This article
Reprint
Photocopy

News summary

Related websites
Archives of Internal Medicine abstract (more)
Circulation abstract (more)

Researchers question need for routine liver function tests with statin therapy

The value of routine follow-up screening for statin-related toxicity has been questioned by researchers.

Dr Christopher Smith, Beth Israel Deaconess Medical Centre, Boston, and colleagues reviewed medical records for 1,194 patients taking a statin. During the one year studied, 85 per cent of patients had at least one monitoring test.

Of the 1,002 patients who had serum transaminase levels tested, 1.0 per cent had significantly abnormal values. A further 0.5 per cent had moderately increased values. None of the increases appeared to be attributable to statins — other medicines such as antiretrovirals, or diseases were considered to be responsible.

Creatine kinase (CK) level was monitored in 645 patients. Abnormal levels were found in 0.9 per cent but none was thought to be attributable to statin use. A further 2.1 per cent had moderately elevated levels and this was thought to be due to statin use in two patients (0.3 per cent of the total).

"The study suggests that among patients receiving statin medications in a primary care practice, the risk of severe transaminase or CK abnormalities attributable to statins is low," the researchers comment. "These results question the necessity of routine laboratory measurements of transaminase and CK values in all patients taking these medications."

The researchers point out that a reduced need for routine screening would substantially cut the costs associated with statin use. But they caution that monitoring is required for patients at increased risk of hepatitis or myopathy (Archives of Internal Medicine 2003;163:688).

The British National Formulary recommends that liver function tests should be carried out before and within one to three months of starting treatment with a statin. Further monitoring should then be undertaken at intervals of six months for one year.