Intolerance to statins only concerns less than 10% of patients treated with these drugs for excess cholesterol. According to the authors of an analysis based on more than 4 million patients, the nocebo effect could explain a large part of the adverse effects reported.
- Statins are drugs used to fight against excess cholesterol
- This excess cholesterol can be the cause of serious cardiovascular diseases.
- Often contested because of adverse effects, statins only cause intolerance in less than 10% of patients
This is a debate that regularly agitates the world of health: can statins, drugs against excess bad cholesterol, be the cause of serious side effects that would modify the benefit/risk balance for patients with hypercholesterolemia? According to a meta-analysis of studies involving more than four million people, intolerance to statins does not exceed 6 to 10%. What makes say to the researchers who carried out this analysis and whose work is published in the European Heart Journal that this intolerance is today “overestimated and overdiagnosed”, which would put patients at risk who reduce or abandon their treatment because of these adverse effects.
A level of intolerance of 9.1%
Until now, the scientific literature announced that the proportion of people intolerant to statins – whose effectiveness has also been demonstrated in the prevention of cardiovascular disease – could vary from 5 to… 50%! A discrepancy that gave free rein to all interpretations on the advisability of following this treatment in the event of excess cholesterol and which can, in fact, cause side effects, in particular muscle pain.
By analyzing the results of 176 studies based on 4,143,500 patients worldwide, researchers from two Polish universities led by Professor Maciej Banach claim to have identified the overall prevalence of statin intolerance which is 9.1%. “These results were not a surprise to me and mean that 93% of patients on statins can be treated effectively and without any safety problems”, emphasizes Pr Banach.
More exposed categories
But then, where would this “bad reputation” of statins come from? Admittedly, the meta-analysis carried out by Maciej Banach’s team shows that certain categories are more likely to be intolerant to these drugs. These are the elderly, female, black or Asian, obese, suffering from diabetes and hepatic or renal insufficiency. Ditto for patients who are already treated with other substances for cardiac arrhythmia, hypertension with calcium channel blockers or who suffer from alcoholism. In these groups, the rates of intolerance noted vary between 22 and 48%.
For all the others, Professor Banach’s team offers another explanation. “We have to very carefully assess the symptoms of patients to see if they are indeed caused by statins but above all to assess the part of the perception that patients have of the harmfulness of these drugs, in other words if their symptoms would not be the result of a nocebo effect”, advances the professor, specifying that this famous effect could explain more than 50% of the symptoms experienced by patients.
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