title: Statin intolerance - an attempt at a unified definition. Position paper from an International Lipid Expert Panel.
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.
authors: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
authors: Maciej
authors: M
authors: Banach
authors: Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors: Manfredi
authors: M
authors: Rizzo
authors: University of Illinois College of Medicine, Peoria, IL, USA.
authors: Peter P
authors: PP
authors: Toth
authors: Department of Lipidology, Point Medical, Dijon, France.
authors: Michel
authors: M
authors: Farnier
authors: Department of Medicine, University of Chicago Medicine, Chicago, IL, USA.
authors: Michael H
authors: MH
authors: Davidson
authors: Department of Clinical Biochemistry, SQUH, Muscat, Oman.
authors: Khalid
authors: K
authors: Al-Rasadi
authors: Cardiology Division, Department of Medicine, Westchester Medical Center/New York Medical College, Valhalla, New York, USA.
authors: Wilbert S
authors: WS
authors: Aronow
authors: Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
authors: Vasilis
authors: V
authors: Athyros
authors: Institute of Medical Physiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Dragan M
authors: DM
authors: Djuric
authors: Department of Atherosclerosis, Cardiology Research Center, Moscow, Russia.
authors: Marat V
authors: MV
authors: Ezhov
authors: California Heart Associates, CA, USA.
authors: Robert S
authors: RS
authors: Greenfield
authors: Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors: G Kees
authors: GK
authors: Hovingh
authors: Mater Hospital, University of Queensland, St Lucia, QLD, Australia.
authors: Karam
authors: K
authors: Kostner
authors: University of Medicine and Pharmacy "Victor Babes" Timisoara, Romania.
authors: Corina
authors: C
authors: Serban
authors: University of Medicine and Pharmacy "Victor Babes" Timisoara, Romania.
authors: Daniel
authors: D
authors: Lighezan
authors: Department of Vascular Medicine, Preventive Cardiology Unit, University Medical Centre Ljubljana, Slovenia Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors: Zlatko
authors: Z
authors: Fras
authors: Department of Medicine, Schools of Pharmacy and Medicine, The University of Kansas Medical Center, Kansas City, KS, USA.
authors: Patrick M
authors: PM
authors: Moriarty
authors: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors: Paul
authors: P
authors: Muntner
authors: Department of Cardiology, Queen Giovanna University Hospital, Sofia, Bulgaria.
authors: Assen
authors: A
authors: Goudev
authors: 3 Department of Internal Medicine, Charles University, Praha, Czech Republic.
authors: Richard
authors: R
authors: Ceska
authors: South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, Australia.
authors: Stephen J
authors: SJ
authors: Nicholls
authors: Department of Internal Medicine and Clinical Pharmacology, Medical University of Lodz, Poland.
authors: Marlena
authors: M
authors: Broncel
authors: Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors: Dragana
authors: D
authors: Nikolic
authors: First Department Of Internal Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, Košice, Slovakia.
authors: Daniel
authors: D
authors: Pella
authors: I P Apollo Hospital, New Delhi, India.
authors: Raman
authors: R
authors: Puri
authors: Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland.
authors: Jacek
authors: J
authors: Rysz
authors: Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA.
authors: Nathan D
authors: ND
authors: Wong
authors: First Department of Medicine, University of Pecs, Pecs, Hungary.
authors: Laszlo
authors: L
authors: Bajnok
authors: The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA.
authors: Steven R
authors: SR
authors: Jones
authors: Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
authors: Kausik K
authors: KK
authors: Ray
authors: Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK.
authors: Dimitri P
authors: DP
authors: Mikhailidis
keywords: definition; muscle symptoms; risk factors; statin intolerance