Statin-associated muscle symptoms are the most frequent side effect, with mild myalgia affecting 5% to 10% of users, while severe symptoms like rhabdomyolysis remain rare.
What are the common statin-associated side effects and how should they be managed in statin users?
Statin-associated symptoms, particularly muscle symptoms and diabetes, are important clinical considerations that require appropriate diagnosis and management to avoid unnecessary discontinuation of life-saving lipid-lowering therapy.
Hydroxy-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors or statins are well tolerated, but associated with various statin-associated symptoms (SAS), including statin-associated muscle symptoms (SAMS), diabetes mellitus (DM), and central nervous system complaints. These are "statin-associated symptoms" because they are rare in clinical trials, making their causative relationship to statins unclear. SAS are, nevertheless, important because they prompt dose reduction or discontinuation of these life-saving mediations. SAMS is the most frequent SAS, and mild myalgia may affect 5% to 10% of statin users. Clinically important muscle symptoms, including rhabdomyolysis and statin-induced necrotizing autoimmune myopathy (SINAM), are rare. Antibodies against HMG-CoA reductase apparently provoke SINAM. Good evidence links statins to DM, but evidence linking statins to other SAS is largely anecdotal. Management of SAS requires making the possible diagnosis, altering or discontinuing the statin treatment, and using alternative lipid-lowering therapy.
Thompson et al. (Sun,) conducted a review in Statin-associated symptoms. Statins (HMG-CoA reductase inhibitors) was evaluated. Statin-associated muscle symptoms are the most frequent side effect, with mild myalgia affecting 5% to 10% of users, while severe symptoms like rhabdomyolysis remain rare.