Abstract
Despite the efficacy of statins in reducing cardiovascular events in both primary and secondary prevention, the adherence to statin therapy is not optimal, mainly due to the occurrence of muscular adverse effects. Several risk factors may concur to the development of statin-induced myotoxicity, including patient-related factors (age, sex, and race), statin properties (dose, lipophilicity, and metabolism), and drug-drug interactions.
Diagnosis
The clinical presentation of statin intolerance typically involves myalgia, muscle weakness, or cramping. Diagnosis is primarily clinical, requiring the exclusion of other common myopathic causes. Monitoring creatine kinase (CK) levels is a standard practice when symptoms become persistent.
Remedies
- Dose Adjustment: Reducing the statin dose or switching to a less potent alternative.
- Alternative Therapies: Evaluating non-statin lipid-lowering agents such as ezetimibe or PCSK9 inhibitors for high-risk patients.
- Lifestyle Changes: Intensification of dietary interventions and regular physical activity management under medical supervision.