title: Muscle-related side-effects of statins: from mechanisms to evidence-based solutions.
abstract: OBJECTIVE
  This article highlights the recent findings regarding statin-associated muscle side effects, including mechanisms and treatment as well as the need for more comprehensive clinical trials in statin myalgia.
  
  
  RESULTS
  Statin myalgia is difficult to diagnose and treat, as major clinical trials have not routinely assessed muscle side-effects, there are few clinically relevant biomarkers and assessment tools for the symptoms, many apparent statin-related muscle symptoms may be nonspecific and related to other drugs or health conditions, and prevalence estimates vary widely. Data thus suggest that only 30-50% of patients with self-reported statin myalgia actually experience muscle pain on statins during blinded, placebo-controlled trials. In addition, evidence to date involving mechanisms underlying statin myalgia and its range of symptoms and presentations supports the hypothesis that there are multiple, interactive and potentially additive mechanisms underlying statin-associated muscle side-effects.
  
  
  CONCLUSIONS
  There are likely multiple and interactive mechanisms underlying statin myalgia, and recent studies have produced equivocal data regarding prevalence of statin-associated muscle side-effects, contributing factors and effectiveness of common interventions. Therefore, more clinical trials on statin myalgia are critical to the field, as are systematic resources for quantifying, predicting and reporting statin-associated muscle side-effects.
authors.affiliation: aDivision of Cardiology, Henry Low Heart Center, Hartford Hospital, Hartford bDepartment of Health Sciences, University of Hartford, West Hartford cUniversity of Connecticut School of Medicine, Farmington, Connecticut, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Taylor
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
mesh_terms: D000818:Animals; D019317:Evidence-Based Medicine; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced*; D063806:Myalgia / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors