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Statin Prescriptions (statin + prescription)
Selected AbstractsPresumed interaction of fusidic acid with simvastatinANAESTHESIA, Issue 6 2008A. J. Burtenshaw Summary A 63-year-old man was admitted 6 weeks after an elective abdominal aortic aneurysm repair following which methicillin resistant Staphylococcus aureus (MRSA) had been cultured from the aneurysmal sac. He had been commenced on a course of fusidic acid at discharge in addition to his ongoing statin prescription and presented 4 weeks later with symptoms consistent with rhabdomyolysis. Severe rhabdomyolysis was confirmed and despite prolonged and complicated critical care management, his treatment was unsuccessful. Extensive investigations ruled out other known causes of this clinical presentation and failed to identify any other precipitating cause of rhabdomyolysis. We believe the most likely cause was hepatic inhibition of the CYP3A4 hepatic isoenzyme by fusidic acid resulting in an acute severe rise in plasma simvastatin level and extensive myocellular damage. Increasing MRSA colonisation and infection rates together with increased statin usage have the potential to increase the incidence of this presumed drug interaction. [source] Some Methods of Propensity-Score Matching had Superior Performance to Others: Results of an Empirical Investigation and Monte Carlo simulationsBIOMETRICAL JOURNAL, Issue 1 2009Peter C. Austin Abstract Propensity-score matching is increasingly being used to reduce the impact of treatment-selection bias when estimating causal treatment effects using observational data. Several propensity-score matching methods are currently employed in the medical literature: matching on the logit of the propensity score using calipers of width either 0.2 or 0.6 of the standard deviation of the logit of the propensity score; matching on the propensity score using calipers of 0.005, 0.01, 0.02, 0.03, and 0.1; and 5 , 1 digit matching on the propensity score. We conducted empirical investigations and Monte Carlo simulations to investigate the relative performance of these competing methods. Using a large sample of patients hospitalized with a heart attack and with exposure being receipt of a statin prescription at hospital discharge, we found that the 8 different methods produced propensity-score matched samples in which qualitatively equivalent balance in measured baseline variables was achieved between treated and untreated subjects. Seven of the 8 propensity-score matched samples resulted in qualitatively similar estimates of the reduction in mortality due to statin exposure. 5 , 1 digit matching resulted in a qualitatively different estimate of relative risk reduction compared to the other 7 methods. Using Monte Carlo simulations, we found that matching using calipers of width of 0.2 of the standard deviation of the logit of the propensity score and the use of calipers of width 0.02 and 0.03 tended to have superior performance for estimating treatment effects (© 2009 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] The impact of over-the-counter simvastatin on the number of statin prescriptions in the United Kingdom: a view from the General Practice Research Database,,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 1 2007Kristian B. Filion MSc Abstract Purpose The United Kingdom (UK) government changed the prescription policy of statins, making low-dose simvastatin (10 mg) available as an over-the-counter (OTC) drug in August 2004. We assessed the impact of this policy change on statin prescribing. Methods We examined all statin prescriptions in the General Practice Research Database (GPRD), a well-validated database of approximately 3.5 million patients, from the first quarter of 2001 to the second quarter of 2005. Results From 2001, the number of statin prescriptions written for GPRD patients was increasing by approximately 437 prescriptions per 100,000 people per quarter until the time of the policy change. Over the four quarters post-policy implementation, however, this trend changed abruptly (p,<,0.0001) with a decrease of 281 prescriptions per 100,000 people per quarter. This decrease was not restricted to prescriptions of 10,mg statins but was also observed for statin prescriptions of ,20,mg. Several other cardiovascular medications displayed a similar trend as that observed in the number of statin prescriptions. This trend was not observed among non-cardiovascular control medications. Conclusions Our study suggests that the policy allowing the OTC sale of 10,mg simvastatin has had a significant impact on statin prescriptions by general practitioners. However, this new policy may also be leading to less aggressive statin therapy. An alternative explanation for the observed decrease in statin prescriptions may be related to the unknown factors responsible for the overall decrease observed with other cardiovascular prescription drugs. Copyright © 2006 John Wiley & Sons, Ltd. [source] The impact of HMG-CoA reductase therapy on serum PSA,THE PROSTATE, Issue 6 2010David J. Mener Abstract BACKGROUND 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors, otherwise known as statins, inhibit the enzyme that controls the conversion of HMG-CoA to mevalonate, a precursor for cholesterol. Statins may be important to prostate cancer biology by inhibiting cell growth, inflammation, and oxidative stress. The purpose of this study was to assess the influence of statin therapy on serum prostate-specific antigen (PSA) levels. METHODS The computerized medical records at the University of Rochester Medical Center were used to identify men who filled statin prescriptions between May 31st, 2008 and September 30th, 2008. Men with at least one PSA assay performed within 2 years before and at least one PSA assay performed within 1 year after starting a statin medication were included. The primary endpoint was the change in PSA concentration computed as the difference between PSA levels before and after starting a statin medication. Paired t -tests were used to analyze the mean differences in PSA values. RESULTS A total of 962 patients were identified. The mean difference in serum PSA level after statin administration was ,0.29,ng/ml (,8.04%). Subgroup analyses for mean PSA concentration change before and after statin administration by age group revealed: 50,59 years old (,0.1609, 95% CI: ,0.2444, ,0.0775, P,<,0.0002), 60,69 years old (,0.3393, 95% CI: ,0.4641, ,0.2145, P,<,0.0001), and >70 years old (,0.351, 95% CI: ,0.490, ,0.212, P,<,0.0001). CONCLUSIONS These observations suggest a statistically significant reduction in serum PSA level that is associated with the onset of statin therapy. Prostate 70: 608,615, 2010. © 2009 Wiley-Liss, Inc. [source] Statin therapy and carotid endarterectomy: a review of trends in New South Wales, 1990,2004ANZ JOURNAL OF SURGERY, Issue 6 2009David A. Robinson Abstract Background:, The number of patients requiring carotid endarterectomy in our hospitals had been noted to be declining. Hence, our aim was to look at the numbers of carotid interventions in our State to see whether this trend was more pervasive and to look at trends in statin prescriptions over the same time-course. Methods:, We queried the New South Wales Department of Health Inpatients Statistics Collection database to determine the number of carotid interventions between 1 July 1990 and 30 June 2004. We also collected data on statin prescriptions from the Health Insurance Commission of the Australian Department of Health and Ageing. The trends in carotid interventions were examined using negative binomial regression. Results:, The rate of carotid interventions increased by 9.8% between 1990 and 1991 and 1997 and 1998 and then declined from 1998 to 1999 through 2003 to 2004 by 6.8%. We noted a similar trend in octogenarians, although the peak was somewhat earlier. The prescription of statins was found to have increased eightfold between 1992 and 2003. Conclusion:, The rate of carotid intervention has declined significantly from a peak in the late 1990s. This peak was at least partly accounted for by North American Symptomatic Carotid Endarterectomy Trial and Advances in Computer Sciences and Technology, studies that were conducted largely before the advent of statins. The number of persons in the community on statins has increased enormously since that time. We ponder over the influence of statins on the natural history of carotid artery disease and the implication this has for future trials of carotid intervention in asymptomatic patients. [source] Switching statins in Norway after new reimbursement policy , a nationwide prescription studyBRITISH JOURNAL OF CLINICAL PHARMACOLOGY, Issue 4 2007Solveig Sakshaug What is already known about this subject ,,Use of statins is growing worldwide and costs represent a burden to public budgets. ,,The introduction of simvastatin generics, generic substitution and price regulations have contributed to price reductions and resulted in overall cost reductions of statin use in Norway. What this study adds ,,New reimbursement regulations for statins in Norway in June 2005, making simvastatin the drug of choice, had a great impact on physicians' prescribing of statins. ,,Nearly 40% of the atorvastatin users switched to simvastatin during the 13-month period after implementation of the new regulations. ,,Among the new users of statins the proportion receiving simvastatin increased from 48% in May 2005 to 92% in June 2006. ,,The new regulations have reduced costs of statins, even though the prevalence of statin use has increased. Aims To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005. Methods Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency. Results One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131 222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from ,120 million to ,95 million when comparing the year before with the year after the new statin regulations. Conclusions The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment. [source] | ||||||||||