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Title: Statin intolerance: an updated, narrative review mainly focusing on muscle adverse effects
Authors: Jian Jun Li
Hui Hui Liu
Na Qiong Wu
Khung Keong Yeo
Kathryn Tan
Junya Ako
Rungroj Krittayaphong
Ru San Tan
Philip E. Aylward
Sang Hong Baek
Jamshed Dalal
Alan Yean Yip Fong
Yi Heng Li
Richard C. O’Brien
Tien Siang Eric Lim
Si Ya Natalie Koh
Daniel J. Scherer
Hayato Tada
Vernon Kang
Julie Butters
Stephen J. Nicholls
Kanazawa University Graduate School of Medical Sciences
South Australian Health and Medical Research Institute
Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
University of Melbourne
Monash University
National Cheng Kung University
Faculty of Medicine, Siriraj Hospital, Mahidol University
The University of Adelaide
Sarawak General Hospital
The University of Hong Kong
Kitasato University
National Heart Centre, Singapore
The Catholic University of Korea
Singapore Heart Foundation
Kokilaben Dhirubhai Ambani Hospital
Keywords: Pharmacology, Toxicology and Pharmaceutics
Issue Date: 1-Jan-2020
Citation: Expert Opinion on Drug Metabolism and Toxicology. (2020)
Abstract: © 2020 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Statins have been established as the standard of care for dyslipidemia and preventing cardiovascular diseases while posing few safety concerns. However, misconceptions about statin intolerance lead to their underuse, indicating a need to improve the understanding of the safety of this treatment. Areas covered: We searched PubMed and reviewed literatures related to statin intolerance published between February 2015 and February 2020. Important large-scale or landmark studies published before 2015 were also cited as key evidence. Expert opinion: Optimal lowering of low-density lipoprotein cholesterol with statins substantially reduces the risk of cardiovascular events. Muscle adverse events (AEs) were the most frequently reported AEs by statin users in clinical practice, but they usually occurred at a similar rate with statins and placebo in randomized controlled trials and had a spurious causal relationship with statin treatment. We proposed a rigorous definition for identifying true statin intolerance and present the criteria for defining different forms of muscle AEs and an algorithm for their management. True statin intolerance is uncommon, and every effort should be made to exclude false statin intolerance and ensure optimal use of statins. For the management of statin intolerance, statin-based approaches should be prioritized over non-statin approaches.
ISSN: 17447607
Appears in Collections:Scopus 2020

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