Science
Statins not the cause of muscle pain in most people who report symptoms
Statins are not the cause of muscle pain in over 90 per cent of people who experience symptoms, according to research we have funded presented today at the European Society of Cardiology Congress in Barcelona and published in The Lancet.
Statins are one of the most commonly prescribed medication in the UK, with up to eight million adults prescribed them to reduce levels of low density lipoprotein (LDL), or ‘bad’ cholesterol in their blood. But side effects, particularly muscle weakness or pain, are reported by many people who take statins.
Now, research led by a team at the University of Oxford has found that muscle pain or weakness is common in adults, regardless of whether they take statins or not. Only one in 15 of reported cases of mild muscle pain or weakness were found to be attributable to statin therapy, and occurred mainly within the first year of treatment.
Similar numbers report symptoms
The researchers compiled data from 23 large studies from the Cholesterol Treatment Trialists’ Collaboration, including information from almost 155,000 people. They used this information to assess the effect of statin therapies on the frequency of muscle-related symptoms across many different patient groups.
Most of the studies the researchers looked at (19 of 23) compared statins to a dummy tablet (placebo). In these studies, similar numbers of people in the statin and placebo groups reported muscle symptoms (27.1 per cent and 26.6 per cent, respectively).
The team found that statins marginally increased the frequency, but not the severity, of muscle-related symptoms. About 14 out of 15 reports of muscle symptoms were not attributed to statins, rising to about 9 in 10 for patients taking a high intensity treatment. This means that statins are not the cause of muscle pain in over 90 per cent of people who report symptoms.
Lifesaving benefits outweigh risk of symptoms
The researchers highlighted that statins are a key tool in helping to reduce the risk of heart and circulatory diseases and that the potential benefits of statin therapy outweigh the risks of muscle pain or weakness.
For every 1000 people taking a moderate intensity statin, the treatment would cause 11 (generally mild) episodes of muscle pain or weakness. This means that the slightly increased risk of muscle symptoms is greatly outweighed by the previously known benefits of statin therapy in preventing cardiovascular disease, including heart attacks and strokes. For example, for every 1000 people taking a moderate intensity statin, the treatment would typically prevent 50 major vascular events (such as heart attacks and strokes) in those with pre-existing vascular disease (secondary prevention), and 25 major vascular events if used for primary prevention.
Continued consultations are important
Professor Sir Nilesh Samani, our Medical Director, said:
“This accumulation of data from many clinical trials provides a clear picture that while statins are associated with a small increase in risk of muscle pains or weakness, they do not cause the majority of muscle pain symptoms commonly associated with them. It reinforces the evidence that statins are safe, which should provide reassurance to the many people taking, or considering taking, these lifesaving drugs that have been proven to protect against heart attacks and strokes.
"However, it also shows how common muscle pain symptoms are. Almost one quarter of patients who participated in the trials reported such symptoms whether they were taking statins or placebo. It is vital that the genuine concerns of people who do experience muscle symptoms are not dismissed and that doctors have continued consultations with these patients to ensure their medication is tailored to work best for them.”
Zena's story
Zena Forster, 66, from Newcastle has been taking statins for six years. She said: "When I first started taking statins I experienced side effects, including muscle aches, pains and cramps. These did have an impact on my day-to-day life and I really struggled to sleep. Despite this, I knew how important it was to keep taking them until I spoke to my GP.
"I hope that this research will bring people some reassurance that any aches and pains they might be experiencing aren’t necessarily due to the statins they are taking. Statins are lifesaving tablets and it’s so important that people persevere and follow their doctor’s advice to take them.
"But it’s also vital that people are listened to if they are experiencing any side effects. People need to feel empowered to discuss these symptoms with their doctor so that they can find a solution together. I feel very grateful that I’ve now found a combination of statins that work well for me and I no longer experience the pain I once did."