10 Steps Before You Refer For: Lipids
10 Steps Before You Refer For: Lipids
The incidence of liver failure in patients taking statins is thought to be 0.5/100,000 person-years (no more than in the non-statin population) implying significant safety margins. Minor elevations of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) – the enzymes to measure – are sometimes seen as part of the normal response to statin therapy and these usually settle. More commonly, elevations of ALT or AST one to three times the upper limit of normal (ULN) reflect non-alcoholic fatty liver disease or excess alcohol. Repeat ALT or AST if >3x ULN and stop the statin if still >3x ULN. If this strategy is followed, half of the abnormalities resolve on re-testing and the statin may be continued. Persistent ALT abnormalities require further investigation. Rises in gamma-glutamyl transferase (GGT) are not relevant to the initiation or continuation of statin therapy.
8. Repeat Liver Function Tests if Raised
The incidence of liver failure in patients taking statins is thought to be 0.5/100,000 person-years (no more than in the non-statin population) implying significant safety margins. Minor elevations of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) – the enzymes to measure – are sometimes seen as part of the normal response to statin therapy and these usually settle. More commonly, elevations of ALT or AST one to three times the upper limit of normal (ULN) reflect non-alcoholic fatty liver disease or excess alcohol. Repeat ALT or AST if >3x ULN and stop the statin if still >3x ULN. If this strategy is followed, half of the abnormalities resolve on re-testing and the statin may be continued. Persistent ALT abnormalities require further investigation. Rises in gamma-glutamyl transferase (GGT) are not relevant to the initiation or continuation of statin therapy.
Source...