Statin-associated muscle symptoms: A comprehensive exploration of epidemiology, pathophysiology, diagnosis, and clinical management strategies. Int J Rheum Dis 2024 Sep;27(9):e15337
Date
09/17/2024Pubmed ID
39285637DOI
10.1111/1756-185X.15337Scopus ID
2-s2.0-85204039705 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
Statins are the first line of treatment for both primary and secondary prevention of atherosclerotic cardiovascular disease. Despite the positive effects of statins on cardiovascular events, not all patients can use them at an optimized dose. The reason for this is the skeletal muscle side effects, termed statin-associated muscle symptoms (SAMS). Despite extensive research, the precise pathophysiology of SAMS remains unclear and multiple mechanisms may contribute to this phenomenon. Various therapeutic options are available for the management of SAMS, ranging from rechallenging with the same or a different statin to utilizing non-statin therapeutic alternatives in patients intolerant to statins. However, the lack of consensus on the definition of SAMS, the absence of a definitive diagnostic test, and lack of a universally accepted management algorithm pose a great challenge in dealing with this entity. This review aims to explore the various pathophysiological mechanisms involved in SAMS and understand the difference between self-limited toxic myopathy and immune-mediated myopathy requiring immunomodulatory therapy. The conundrum of statin withdrawal, tapering, and rechallenge in SAMS will also be explored in detail along with the newer non-statin therapies that are available.
Author List
Shah M, Shrestha K, Tseng CW, Goyal A, Liewluck T, Gupta LAuthor
Karun Shrestha MBBS Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
HumansHydroxymethylglutaryl-CoA Reductase Inhibitors
Muscle, Skeletal
Muscular Diseases
Predictive Value of Tests
Risk Factors
Treatment Outcome
