“Our results confirm that, in most cases, statin therapy is not likely to be the cause of muscle pain in a person taking statin therapy,” said the study, led by authors from Oxford Population Health and the Medical Research Council Population Health. Oxford University Research Unit. “This finding is particularly true if treatment has been well tolerated for a year or more before symptoms develop.”
The authors performed a meta-analysis of 19 double-blind randomized trials of statin regimens versus placebos. All trials had more than 1,000 participants and at least two years of follow-up. They also looked at four double-blind trials of more and less intense statin regimens.
Study author Colin Baigent, professor of epidemiology at the University of Oxford, said there have been many non-randomized studies that do not involve any kind of placebo or random assignment to a statin that have produced estimates ” really quite extreme” of how Many muscle pains are caused by statins.
“This has caused patients not to start statins or to stop treatment when they develop muscle pain because they simply look on paper and see that statins cause lots and lots of muscle pain and so they stop,” he said. Downloading during a Science Media. Center briefing. “We were really trying to deal with this problem.”
The new study says that “even during the first year of a moderate-intensity statin regimen, it is likely to be the cause in only about one in 15 patients who report muscle symptoms, rising to about one in every 10 in those taking a more intensive regimen.
“In other words, the statin is not the cause of muscle symptoms in more than 90% of people who report these symptoms.”
The authors found that during the first year, statin therapy produced a 7% relative increase in muscle pain or weakness, but after that there was no significant increase. The increased risk was already present during the first three months after treatment allocation.
There were reports of at least one episode of muscle pain or weakness by 27.1% of patients assigned a statin versus 26.6% of those receiving placebo during a mean follow-up of 4.3 years.
In the trials analyzed by the authors, they say that statin therapy, during the first year of use, led to approximately 11 additional reports of muscle pain per 1,000 patients.
“What we conclude is that there are two things that we need to do as a profession, as a society,” Baigent said at the briefing. “The first is that we need to better manage patients who report muscle pain when taking a statin, because there is a tendency for patients to end up stopping the statin and that has a detrimental effect on their long-term health. And the second thing we need to do is look at the information that is available to patients in the leaflets.”
He noted that if people were better informed about the real risks of muscle pain, then they might stay on statin therapy for longer.
The study has some limitations, including considerable heterogeneity in the methods used for muscle symptoms, some adverse event data being unavailable, and most studies not excluding participants who can now be classified as statin intolerant. .
In a commentary published alongside the study, Dr Maciej Banach, a cardiologist at the Medical University of Lodz and the Research Institute of the Polish Mother’s Memorial Hospital, wrote that the possible side effects of statins they should not be considered when starting treatment.
“It must be strongly emphasized that the small risk of muscle symptoms is negligible compared to the well-proven cardiovascular benefits of statins,” he wrote.
The US Centers for Disease Control and Prevention says that heart disease is the leading cause of death among men, women and those of most racial and ethnic groups in the United States. There is a death from cardiovascular disease every 34 seconds in the country.
Last week, the US Preventive Services Task Force announced its latest guidance on using statins to prevent a first heart attack or stroke.
The guidelines are more conservative than those proposed by other groups, such as the American College of Cardiology. They recommend statins in adults aged 40 to 75 who have at least one cardiovascular disease risk factor and a 10% or higher risk of a heart attack in the next 10 years.
According to the American Heart Association, “statins are recommended for most parts and have been directly associated with a reduction in the risk of heart attack and stroke. Statins continue to provide the most effective lipid-lowering treatment in most of the cases”.