New insights into managing symptoms during statin therapy

Prog Cardiovasc Dis. 2019 Sep-Oct;62(5):390-394. doi: 10.1016/j.pcad.2019.10.005. Epub 2019 Oct 26.

Abstract

Symptoms during statin therapy are common and often attributed to statin intolerance. Recent data suggest few patients are truly intolerant to statins. Muscle symptoms are similar in statin and control groups in blinded treatment periods of clinical trials. The "nocebo" effect may occur during open-label statin treatment, when previously asymptomatic study participants report symptoms attributed to statin therapy, or during placebo-controlled trials. Most patients reporting statin intolerance can tolerate blinded moderate intensity statin therapy. In clinical practice the large majority of patients are willing to retry a statin, and of those who do, >80-90% successfully remain on statin therapy long-term. Emerging evidence from brain imaging studies and contemporary approaches to pain management suggests that building trust and managing patient expectations can minimize the "nocebo" effect in statin-treated patients.

Keywords: Nocebo effect; Pain management; Prevention; Statins.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Clinical Trials as Topic
  • Dyslipidemias / blood
  • Dyslipidemias / diagnosis
  • Dyslipidemias / drug therapy*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Lipids / blood*
  • Muscular Diseases / chemically induced
  • Muscular Diseases / epidemiology
  • Muscular Diseases / therapy*
  • Nocebo Effect
  • Observational Studies as Topic
  • Risk Assessment
  • Risk Factors

Substances

  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids