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Statin-Induced Myopathy 
and its Management

Catherine Buettner, MD, MPH1,2, Martin A Kriegel, MD1,2,3, Rebecca E Wells, MD, MPH1,2, and Jim S Wu, MD1,2

Statins (3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors) are the most efficacious medications for lowering cholesterol [1]. They are usually well tolerated, with few serious side-effects [2]. However, muscle symptoms and/or creatine kinase (CK) elevations are considered the most common and important adverse effects [3] and may lead to discontinuation of these beneficial medications, which have been proven to significantly reduce cardiovascular (CV) events as well as CV and all-cause mortality rates [4–6]. Muscle-related side-effects are usually mild to moderate in severity [7,8] and are reversible [8,9], whereas severe adverse effects are extremely rare [9–11]. However, patients often underestimate the risk associated with high cholesterol or heart disease and overestimate the risk posed by muscle symptoms, worrying that they may lead to serious muscle disease. Conversely, healthcare providers may underestimate the impact that muscle symptoms can have on a patient’s quality of life. The risk:benefit ratio of continuing statin therapy needs to be considered according to each patient’s individual needs in the context of the side-effects experienced.

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