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Statin-related Muscle Toxicity: An Evidence-based Review
Mohammad S Jeeyavudeen1, Joseph M Pappachan2,3, Ganesan Arunagirinathan1
1Western General Hospital, Edinburgh Centre for Endocrinology Diabetes, Edinburgh, UK.
Abstract:
The efficacy of statins in the primary and secondary prevention of cardiovascular disease has been proven beyond doubt. The number needed to treat to prevent one cardiovascular event is 1 in 30 over 10 years, and the number needed to treat for secondary prevention is much lower. However, a recent study demonstrated that only 68% of eligible patients are on statin therapy. Moreover, there seems to be a reluctance to escalate statin doses due to the fear of adverse effects. The adverse effects that worries patients and their physicians most frequently are those related to muscular symptoms. N-of-1 trial evidence suggests that muscular symptoms attributed to statins are often caused by the nocebo effect. This article aims to provide a structured, evidence-based approach to suspected statin-related muscle toxicity.
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