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Treatment Options for Statin-Associated Muscle Symptoms.
Dtsch Arztebl Int. 2015 Oct 30; 112(44):748-55.DA

Abstract

BACKGROUND

About 4.6 million persons in Germany are now taking statins, i.e., drugs that inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMGCoA) reductase. Statins lower the concentration of low-density lipoproteins (LDL) and thereby lessen the rate of cardiovascular events; the size of this effect depends on the extent of lowering of the LDL cholesterol concentration. Muscle symptoms are a clinically relevant side effect of statin treatment.

METHODS

This review is based on pertinent publications retrieved by a selective literature search, and on the current recommendations of the European Atherosclerosis Society.

RESULTS

At least 5% of patients taking statins have statin-associated muscle symptoms (SAMS). The etiology of SAMS is heterogeneous. SAMS may seriously impair quality of life and cause complications of variable severity, up to and including rhabdomyolysis (in about 1 in 100,000 cases). SAMS often lead to a reduction in the prescribed dose of the statin, while also negatively affecting drug adherence. More than 90% of patients with SAMS can keep on taking statins over the long term and gain the full clinical benefit of statin treatment after a switch to another type of statin or a readjustment of the dose or frequency of administration. If the LDL cholesterol concentration is not adequately lowered while the patient is taking a statin in the highest tolerable dose, combination therapy is indicated.

CONCLUSION

SAMS are important adverse effects of statin treatment because they lessen drug adherence. Patients with SAMS should undergo a thorough diagnostic evaluation followed by appropriate counseling. In most cases, statins can be continued, with appropriate adjustments, even in the aftermath of SAMS.

Authors+Show Affiliations

Department of Internal Medicine III-Cardiology, Angiology and Intensive Care Medicine, Saarland University Medical Center, Homburg/Saar, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Department of Prevention, Rehabilitation and Sports Medicine and Else Kroener-Fresenius-Center for Nutritional Medicine, Klinikum rechts der Isar, Technische Universität München, Preventive Medicine, Department of General and Interventional Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Department and Out-Patient Care of Neurology, Charité-Universitätsmedizin Berlin, Synlab Akademie, Synlab Services GmbH, Mannheim and Augsburg.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26575138

Citation

Laufs, Ulrich, et al. "Treatment Options for Statin-Associated Muscle Symptoms." Deutsches Arzteblatt International, vol. 112, no. 44, 2015, pp. 748-55.
Laufs U, Scharnagl H, Halle M, et al. Treatment Options for Statin-Associated Muscle Symptoms. Dtsch Arztebl Int. 2015;112(44):748-55.
Laufs, U., Scharnagl, H., Halle, M., Windler, E., Endres, M., & März, W. (2015). Treatment Options for Statin-Associated Muscle Symptoms. Deutsches Arzteblatt International, 112(44), 748-55. https://doi.org/10.3238/arztebl.2015.0748
Laufs U, et al. Treatment Options for Statin-Associated Muscle Symptoms. Dtsch Arztebl Int. 2015 Oct 30;112(44):748-55. PubMed PMID: 26575138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment Options for Statin-Associated Muscle Symptoms. AU - Laufs,Ulrich, AU - Scharnagl,Hubert, AU - Halle,Martin, AU - Windler,Eberhard, AU - Endres,Matthias, AU - März,Winfried, PY - 2015/04/29/received PY - 2015/08/10/revised PY - 2015/08/10/accepted PY - 2015/11/18/entrez PY - 2015/11/18/pubmed PY - 2016/12/15/medline SP - 748 EP - 55 JF - Deutsches Arzteblatt international JO - Dtsch Arztebl Int VL - 112 IS - 44 N2 - BACKGROUND: About 4.6 million persons in Germany are now taking statins, i.e., drugs that inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMGCoA) reductase. Statins lower the concentration of low-density lipoproteins (LDL) and thereby lessen the rate of cardiovascular events; the size of this effect depends on the extent of lowering of the LDL cholesterol concentration. Muscle symptoms are a clinically relevant side effect of statin treatment. METHODS: This review is based on pertinent publications retrieved by a selective literature search, and on the current recommendations of the European Atherosclerosis Society. RESULTS: At least 5% of patients taking statins have statin-associated muscle symptoms (SAMS). The etiology of SAMS is heterogeneous. SAMS may seriously impair quality of life and cause complications of variable severity, up to and including rhabdomyolysis (in about 1 in 100,000 cases). SAMS often lead to a reduction in the prescribed dose of the statin, while also negatively affecting drug adherence. More than 90% of patients with SAMS can keep on taking statins over the long term and gain the full clinical benefit of statin treatment after a switch to another type of statin or a readjustment of the dose or frequency of administration. If the LDL cholesterol concentration is not adequately lowered while the patient is taking a statin in the highest tolerable dose, combination therapy is indicated. CONCLUSION: SAMS are important adverse effects of statin treatment because they lessen drug adherence. Patients with SAMS should undergo a thorough diagnostic evaluation followed by appropriate counseling. In most cases, statins can be continued, with appropriate adjustments, even in the aftermath of SAMS. SN - 1866-0452 UR - https://www.unboundmedicine.com/medline/citation/26575138/Treatment_Options_for_Statin_Associated_Muscle_Symptoms_ L2 - https://doi.org/10.3238/arztebl.2015.0748 DB - PRIME DP - Unbound Medicine ER -