Statin Intolerance: Not a Myth
Discussion around statin intolerance (SI) on the invitation by Professor Banach discusses the statin intolerance issue as well as recent Position Paper on the joined definition of SI from International Lipid Expert Panel (ILEP).
Statins are one of the most commonly prescribed drugs.1 They are generally well tolerated and prevent cardiovascular events.2 However, as with all drugs, they can have adverse effects (AEs). Most of the AEs are muscle-related; however, there are also other statin-associated AEs. The recent European Atherosclerosis Society (EAS) statement only focuses on statin-associated muscle symptoms (SAMS) and avoids the use of the term 'statin intolerance,' as it is not specific for SAMS.3 It has also been suggested to avoid using the term 'statin intolerance' as it might create a negative impression.

Although SAMS are the most common AEs observed with statin administration, excluding other symptoms might underestimate the number of patients who have poor adherence to this treatment. Therefore, an expert panel aimed to provide a unified definition of statin intolerance and advice on managing the most common conditions that might increase the risk of intolerance to statins.4,5 This statement complements that of the EAS, whereas the pathophysiology, diagnosis, and the management of SAMS were comprehensively presented.3

Briefly, statin intolerance is the inability to tolerate a dose of statin required to sufficiently reduce cardiovascular risk. This could result from different statin-related side effects. Statin intolerance limits the effective treatment of patients at risk of, or with, cardiovascular disease (CVD). Therefore, knowledge of the common AEs associated with statin therapy (not only SAMS) is crucial to ensure effective treatment of lipid disorders. In turn, this awareness could significantly reduce the risk of discontinuing statin therapy (or need to reduce the dose of statin), thus improving adherence and increasing the effectiveness of treatment (...).

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