Statin-Associated Muscle Symptoms: Clinical Index in a hypertensive population candidated to lipid-lowering therapy but not taking statins

Selected Abstract – Spring Meeting 2023

Riccardo Sarzani
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy; and Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
Federico Giulietti
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy
Massimiliano Allevi
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy; and Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
Silvia Sarnari
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy; and Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
Romina Alessandroni
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy; and Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy
Chiara Di Pentima
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy
Francesco Spannella
Internal Medicine and Geriatrics, IRCCS INRCA, Ancona, Italy; and Department of Clinical and Molecular Sciences, University “Politecnica delle Marche”, Ancona, Italy

Abstract

Aim: Statin-associated muscle symptoms (SAMS) are claimed to be frequent in clinical practice. The SAMS-clinical index (SAMS-CI) assesses the likelihood that muscle symptoms are related to statin use. We evaluated the prevalence and characteristics of muscle symptoms in hypertensive patients eligible for statin therapy according to their individual cardiovascular risk.
Methods: Observational study on 390 consecutive outpatients referred to our Centre. All patients were asked the following question: “Have you ever taken a drug/nutraceutical that you think gave you muscle symptoms?”. Patients who answered “yes” were evaluated with SAMS-CI.
Results: Mean age: 60.5±13.5 years. Male prevalence: 53.8%. Patients who have ever taken a statin (“statin+” group): 250. Patients who have never taken a statin but have taken at least one other drug (“statin-” group): 140. Prevalence of muscle symptoms did not differ between the groups (p=0.217). Age and number of drugs taken were significantly associated with muscle symptoms at multivariate analysis. A not clinically significant higher SAMS-CI score emerged in the “statin+” group (p=0.004). Localization and pattern of muscle symptoms did not differ between the groups (p=0.170). Timing of muscle symptoms onset after starting the drug (p=0.036) and timing of symptom improvement after withdrawal (p=0.002) were associated with statin therapy.
Conclusions: Prevalence of patient-reported muscle symptoms was not associated with statin therapy in our real life clinical study, confirming the growing evidence that subjective muscle-related symptoms are often misattributed to statins, while they may more likely be related to the nocebo/drucebo effect or other common undiagnosed conditions.

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