The risks of developing myopathy and muscle pain among statin users may be small and clinically insignificant

1. 27.1% of patients in the statins group reported muscle pain and weakness compared to 26.6% in the control group.

2. The risk of symptoms appears to be more common among patients in the higher-dose statins group.

Directory rating level: 1 (excellent)

Study rundown: Statins are lipid-lowering agents that reduce the risk of cardiovascular disease through inhibition of the HMG-CoA reductase enzyme. Known, but rare, side effects of statins include myopathy and muscle pain. However, whether these symptoms are caused by statins themselves is controversial. This meta-analysis aims to assess the effect of statin therapy on muscle pain and weakness using evidence from 19 randomized, placebo-controlled trials. The primary outcome was statin-related muscle pain at 1 year, while the main secondary outcomes included increased muscle pain and weakness as well as an elevation in creatine kinase. According to the results of the study, patients in the statins group reported an increase in mild muscle pain, although this was not caused by the statins. Furthermore, most cases of muscle pain or weakness occurred in the first year and did not lead to treatment discontinuation because it was considered clinically mild. This study was reinforced by the accumulation of data from several large, well-conducted randomized trials, which added to its validity.

Click to read the study at The Lancet

Related reading: 20-year follow-up of statins in children with familial hypercholesterolemia

in depth [meta-analysis]: This study consisted of patients from 19 double-blind trials of statin versus placebo (n=93,940) and 4 double-blind trials of the more-versus-low intensity statin regimen (n=30,724) between 1994 and 2016. ≥ 1,000 patients were on drug treatment Cholesterol lowering for two years. Among the placebo-controlled trials, the mean age of patients was 63 years (standard deviation [SD] 8) and 48.1% (n = 59,610) had previous vascular disease. The primary outcome for myalgia and myopathy was marginally greater in the statin treatment group (n=16835, 27.1%) compared to placebo (n=16446, 26.6%; rate ratio [RR] 1.03, 95% confidence interval [CI] 1.01-1.06). The dose-dependent effect was seen as a more intense regimen versus placebo that resulted in more symptoms (RR 1.08, 95% CI 1.04–1.13) compared to the less intense regimen versus placebo (RR 1.03, 1.00–1.05). In the first year of statin therapy, there was a 7% RR increase in muscle pain and weakness (RR 1.07, 1.04-1.10); However, after the first year, the increased muscle pain attributable to statin use was not observed (RR 0.99, 0.96-1.02). Statin therapy led to a moderate increase in creatine kinase levels. Overall, the results of this study suggest that while statins may increase the likelihood of developing myalgia and myopathy, this does not appear to be related to treatment. Furthermore, the cardiovascular benefits of statins far outweigh their risks.

Photo: PD

© 2022 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without the express written consent of 2 Minute Medicine, Inc. Inquire about a license over here. No article should be construed as medical advice and is not intended by the authors or 2 Minute Medicine, Inc.