Lipid lowering drugs induced adverse cutaneous drug reactions
- Author:
Lee Chew Kek
;
Lee YY
;
Roshidah B
- Publication Type:Review
- Keywords:
Adverse Drug Reaction, Antilipemic Agents, Anticholesteremic Agents, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, Drug Hypersensitivity, Simvastatin, Lovastatin, Gemfibrozil
- From:Malaysian Journal of Dermatology
2011;27(-):22-22
- CountryMalaysia
- Language:English
-
Abstract:
Background:
Lipid lowering drugs (LLDs) are widely used. However, reports on its adverse cutaneous drug reactions (ACDRs) are
scarce.
Objectives:
The study objective was to review the patterns of LLD induced ACDRs.
Methods:
We reviewed all LLDs induced ACDRs reported to MADRAC (Malaysian Adverse Drug Reaction Advisory Committee) from
January 2005 till December 2009.
Results:
LLD induced ACDRs (124 patients) comprised of 2.07% of all ACDRs reported during the study period. Statins were
responsible for most cases (81.5%), followed by fibrates (15.8%), selective cholesterol-absorption inhibitors (1.4%) and
combination therapies (statin/selective cholesterol-absorption inhibitors and selective prostaglandin-2 receptor inhibitor/
niacin) in 1.4%. Majority were due to lovastatin (42.5%), simvastatin (28.1%) and gemfibrozil (8.9%). The three commonest
ACDRs reported with statins usage were non-specific dermatitis (45.0%), pruritus/stinging (25.0%) and urticaria/angioedema
(10.0%) while fibrates caused non-specific dermatitis (52.2%), urticaria/angioedema (13.0%) and photodermatitis (9.7%).
There was no reported case of photodermatitis associated with statin usage. Interestingly, statins were the offending
drugs resulting in all the five cases of vesiculobullous eruptions, two cases of Stevens-Johnson syndrome and one case of
dermatomyositis. No mortalities were reported to be associated with LLD induced ACDRs.
Conclusions:
LLD induced ACDRs were not uncommon. Statins were the main putative drugs implicated in those reactions. Spectrum
of ACDRs differed between statin and fibrate although non-specific dermatitis remained the main ACDRs in both classes.
The unavailability of guided and classified ACDRs reporting accounted for the large number of non-specific dermatitis.
Although most LLD induced ACDRs were mild, statins were reported to cause severe ACDRs.