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Review
. 2018 Oct;15(4):1006-1017.
doi: 10.1007/s13311-018-0670-z.

Statin-Associated Muscle Disease: Advances in Diagnosis and Management

Beth A Taylor  1   2   3 , Paul D Thompson  4   5
Affiliations
Review

Statin-Associated Muscle Disease: Advances in Diagnosis and Management

Beth A Taylor et al. Neurotherapeutics. 2018 Oct.

Abstract

Since the first approval of lovastatin in 1987, hydroxy-methyl-glutaryl CoA (HMG CoA) reductase inhibitors, or statins, have been effective and widely popular cholesterol-lowering agents with substantial benefits for the prevention and treatment of cardiovascular disease. Not all patients can tolerate these drugs, however, and statin intolerance is most frequently associated with a range of side effects directed toward skeletal muscle, termed statin-associated muscle symptoms or SAMS. SAMS are particularly difficult to treat because there are no validated biomarkers or tests that can be used to confirm patient self-reports of SAMS, and a number of patients who report SAMS have non-specific muscle pain not attributable to statin therapy. This review summarizes the most recent evidence related to diagnosis and management of SAMS. First, the range of skeletal muscle side effects associated with statin therapy is described. Second, data regarding the incidence and prevalence of SAMS, the most frequently experienced muscle side effect, are presented. Third, the most promising new techniques to confirm diagnosis of SAMS are explored. Finally, the most effective strategies for the clinical management of SAMS are summarized. Better diagnostic and treatment strategies for SAMS will increase the number of patients using these life-saving statins, thereby increasing statin adherence and reducing the costs of avoidable cardiovascular events.

Keywords: Myalgia; Skeletal muscle; Statin intolerance; Statin-associated muscle symptoms; Statins.

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Figures

Fig. 1
Fig. 1
The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI). The SAMS-CI [51] is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium
Fig. 2
Fig. 2
A schematic of the diagnosis, treatment, and management strategies for SAMS
See this image and copyright information in PMC

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