Statin-Associated Muscle Symptoms: Identification and Recommendations for Management

Curr Atheroscler Rep. 2024 Nov 18;27(1):5. doi: 10.1007/s11883-024-01246-y.

Abstract

Purpose of review: Statins are first-line pharmacotherapy for the treatment of elevated low-density lipoprotein cholesterol and are generally well-tolerated. However, some patients may experience statin-associated muscle symptoms (SAMS). This paper reviews recommendations for identification and management of patients with SAMS.

Recent findings: The National Lipid Association and other professional societies have issued guidance to assist clinicians in identifying and managing patients with partial or complete statin intolerance. The most common reason for intolerance is SAMS. This review discusses strategies to achieve therapeutic objectives for atherogenic lipoprotein management in patients with SAMS. Many patients who experience SAMS can tolerate some degree of statin therapy and non-statin medications are available as adjunctive or alternative treatments. With a thorough clinician-patient discussion and shared decision-making, a treatment plan can be identified to achieve therapeutic objectives and reduce the risk of atherosclerotic cardiovascular disease.

Keywords: Atherogenic Lipoproteins; Nocebo Effect; Statin Intolerance; Statin-associated Muscle Symptoms; Statin-associated Side Effects.

Publication types

  • Review

MeSH terms

  • Cholesterol, LDL / blood
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Muscular Diseases* / chemically induced
  • Muscular Diseases* / therapy
  • Practice Guidelines as Topic

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol, LDL