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Arch Med Sci. 2015 Mar 16;11(1):1-23. doi: 10.5114/aoms.2015.49807. Epub 2015 Mar 14.

Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.

Author information

1
Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
2
Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
3
University of Illinois College of Medicine, Peoria, IL, USA.
4
Department of Lipidology, Point Medical, Dijon, France.
5
Department of Medicine, University of Chicago Medicine, Chicago, IL, USA.
6
Department of Clinical Biochemistry, SQUH, Muscat, Oman.
7
Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York, USA.
8
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
9
Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
10
Department of Atherosclerosis, Cardiology Research Center, Moscow, Russia.
11
California Heart Associates, CA, USA.
12
Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
13
Mater Hospital, University of Queensland, St Lucia, QLD, Australia.
14
University of Medicine and Pharmacy "Victor Babes" Timisoara, Romania.
15
Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
16
Department of Medicine, Schools of Pharmacy and Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.
17
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
18
Department of Cardiology, Queen Giovanna University Hospital, Sofia, Bulgaria.
19
3 Department of Internal Medicine, Charles University, Praha, Czech Republic.
20
South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, Australia.
21
Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Poland.
22
First Department Of Internal Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, KoŇ°ice, Slovakia.
23
I P Apollo Hospital, New Delhi, India.
24
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA.
25
First Department of Medicine, University of Pecs, Pecs, Hungary.
26
The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
27
Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
28
Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.

Abstract

Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin associated muscle symptoms (SAMS), and avoided the use of the term 'statin intolerance'. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10-15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.

KEYWORDS:

definition; muscle symptoms; risk factors; statin intolerance

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