Statin-associated muscle symptoms: position paper from the Luso-Latin American Consortium

Abstract

In the last two decades, statin therapy has proved to be the most potent isolated therapy for attenuation of cardiovascular risk. Its frequent use has been seen as one of the most important elements for the reduction of cardiovascular mortality in developed countries. However, the recurrent incidence of muscle symptoms in statin users raised the possibility of causal association, leading to a disease entity known as statin associated muscle symptoms (SAMS). Mechanistic studies and clinical trials, specifically designed for the study of SAMS have allowed a deeper understanding of the natural history and accurate incidence. This set of information becomes essential to avoid an unnecessary risk of severe forms of SAMS. At the same time, this concrete understanding of SAMS prevents overdiagnosis and an inadequate suspension of one of the most powerful prevention strategies of our times. In this context, the Luso-Latin American Consortium gathered all available information on the subject and presents them in detail in this document as the basis for the identification and management of SAMS.

Keywords:

• Intolerance
• statin
• statin associated muscle symptoms

Transparency

Declaration of funding

This position statement was not commercially funded. The consortium has the support of the Sociedade Brasileira de Cardiologia, Sociedad Argentina de Lipidos, Asociación Chilena de Nutrición y Metabolismo, Sociedade Portuguesa de Aterosclerose, Sociedad Mexicana de Cardiologia and Asociación Colombiana de Medicina Interna.

Declaration of financial/other relationships

A.C.S., J.R.F.N., L.S.F.C., A.L., A.C., G.E., E.E., E.C.M.V., L.C.B., R.K.A., A.J.R.M., V.Z.R., A.A.F., H.T.X., O.R.C., M.H.A., M.C.I., R.D.S., F.A.H.F., A.M.S., P.M.S., and M.C.B. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewer 1 has disclosed that he has received personal fees from AstraZeneca and Pfizer; grants and fees from MDS; personal fees and non-financial support from Abbott, Boehringer Ingelheim, and Eli Lilly, and non-financial support and other fees from GSK. Peer reviewer 2 has disclosed that she/he has given talks for and is on the advisory board of various pharmaceutical companies.

Acknowledgments

We acknowledge José Carlos Quinaglia e Silva and Osorio Luis Rangel de Almeida for the insighful discussions on the topic of this Statement.