Statin-related Muscle Toxicity: An Evidence-based Review.

TouchREVIEWS in endocrinology Pub Date : 2022-11-01 Epub Date: 2022-11-21 DOI:10.17925/EE.2022.18.2.89
Mohammad S Jeeyavudeen, Joseph M Pappachan, Ganesan Arunagirinathan
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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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他汀类药物相关肌肉毒性:基于证据的综述。
他汀类药物在心血管疾病一级和二级预防中的疗效已被证明是毋庸置疑的。在 10 年内预防一次心血管事件所需的治疗人数为 30 分之 1,而二级预防所需的治疗人数要低得多。然而,最近的一项研究表明,只有 68% 的合格患者在接受他汀类药物治疗。此外,由于担心不良反应,人们似乎不愿意增加他汀类药物的剂量。最让患者及其医生担心的不良反应是与肌肉症状有关的不良反应。N-of-1试验证据表明,他汀类药物引起的肌肉症状通常是由 "预兆效应"(nocebo effect)引起的。本文旨在为怀疑他汀类药物相关的肌肉毒性提供一种结构化的循证方法。
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