PhD Scientific Days 2024

Poster Session B - Pharmaceutical Sciences and Health Technologies 1.

Systematic Review on Adjusting Statin Dosage for the Elderly

Text of the abstract

Introduction: Statins, fundamental in lipid-lowering treatment, show notable effectiveness in lowering the risk of atherosclerotic cardiovascular disease (ASCVD). Nonetheless, the primary side effect of statins, rhabdomyolysis, causes muscle tissue breakdown, particularly impacting frail, elderly individuals with multiple medications and health conditions. Despite this, there is currently insufficient guidance in clinical protocols regarding adjusting statin dosages for elderly patients.

Objective: The aim of this study is to perform a systematic literature review focused on statin use in the geriatric population, analyze the benefit-risk ratio from relevant studies, and appraise various dosage protocols.

Methods: Four databases were searched: PubMed (174 records), Scopus (60 records), Web of Science (3 records), EBSCO (173 records). Among these, 11 original studies comprising a total of 566,509 patients were selected for review. The examined time period ranged from 1994 to 2024. Results were analyzed based on statin dosing, laboratory parameters, and clinical outcomes.

Results: As expected, statin therapy markedly decreased the incidence of cardiovascular disease (CVD) compared to placebo. However, a fixed low-dose statin showed a smaller reduction in CVD risk compared to a higher-intensity statin that was adjusted during the study. Titration of statin dosages enabled the use of higher levels while keeping the likelihood of side effects similar to that of low doses. Furthermore, combining therapies was found to be more effective than statin titration alone in reducing the risk of CVD, with a comparable probability of side effects at lower doses.

Conclusion: Statin therapy effectively reduces the risk of cardiovascular diseases in elderly patients, both for primary and secondary prevention. The risk of side effects can be mitigated through dose adjustments or by combining statins with ezetimibe. Treatment adherence, which poses a challenge in the elderly, plays a critical role in achieving positive clinical outcomes. Implementing measures to improve adherence could significantly improve the effectiveness of treatment.