Prescribed in case of cholesterol, statins are associated with muscle and joint pain. However, a new study shows that they do not cause more side effects than a placebo.
- Contrary to what some patients think, statins do not cause muscle pain.
Prescribed to fight against cholesterol, statins represent the main class of lipid-lowering drugs: they inhibit the functioning of HMG Co A reductase, an enzyme which controls the synthesis of cholesterol by hepatic cells. This inhibition also stimulates the expression of LDL receptors, allowing their entry into the target cell.
In France, an estimated 6.4 million patients are currently on statin therapy. Although well tolerated, approximately one in five patients discontinue treatment due to side effects. The main reported on muscle and joint pain, as well as fatigue. A new study published this Thursday, February 25 in the British Medical Journal finds, however, that statins have no effect on the frequency or severity of muscle symptoms.
No difference between statins and placebos
To reach this conclusion, the researchers followed 200 patients (mean age 69.5 years) from 50 general practices in England and Wales, who had recently stopped or were considering stopping their treatment with statins due to muscle symptoms.
Each patient was randomly assigned to a sequence of six two-month treatment periods during which they received either statins or a placebo. Neither the patients nor their doctor knew which tablet they were receiving. 80% of patients reported taking their medication “every day” or “most days” during each period.
At the end of each treatment period, participants were asked to rate their muscle symptoms on a scale of 0 to 10 points. The results showed that there was no difference in muscle symptom scores between the statin and placebo periods. No differences were also found in the effect of muscle symptoms on aspects of daily living (general activity, mood, ability to walk, normal work, relationships with others, sleep, and enjoyment of life) between periods. statins and placebos.
A “nocebo effect”
Among participants who dropped out due to intolerable muscle symptoms, 9% were on statins (18 patients) and 7% on placebo (13 participants). Two-thirds of participants who completed the trial said they planned to return to long-term treatment with statins.
While the researchers point out that they only evaluated the effect of one type of statin (atorvastatin 20mg) on muscle symptoms, they say it is a “large, well-designed trial, based on repeated measures of muscle pain in patients who had experienced symptoms during statin treatment, which more accurately assessed the differences between statins and placebo.”They now plan to conduct new trials to establish the effects of other types of statins and test higher doses.
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