The DOI matches its Crossref record; 82 of the 83 references it cites were found in a registry or an index, and 1 are not checked yet.
Assessment and management of statin-associated muscle symptoms (SAMS): A clinical perspective from the National Lipid Association
Open accessAbstract
Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance and are associated with increased risk of cardiovascular events that manifest from statin underutilization and discontinuation. The reported frequencies of SAMS are divergent in the literature. The writing group estimates the prevalence of SAMS, namely all muscle symptoms temporally related to statin use but without regard to causality, to be about 10% (range 5% to 25%), and the prevalence of pharmacological SAMS, specifically muscle symptoms resulting from pharmacological properties of the statin, to be about 1-2% (range 0.5% to 4%). In clinical practice, SAMS are likely to result from a combination of pharmacological and nonpharmacological effects, however this does not make the symptoms any less clinically relevant. Regardless of the etiology, SAMS need to be addressed in accordance with patients' preferences and experiences. This clinical perspective reviews the epidemiology and underlying pathophysiology of SAMS, and the cardiovascular consequences resulting from statin discontinuation. We present patient-centered clinical and communication strategies to mitigate SAMS and improve medication adherence and outcomes among statin users. Treatment strategies include 1) optimizing lifestyle interventions, 2) modulating risk factors that may contribute to muscle symptoms, 3) optimizing statin tolerability by dose reduction, decreased dosing frequency, or use of an alternate statin with more favorable pharmacokinetic properties, and 4) use of non-statins, emphasizing those with evidence for atherosclerotic risk reduction, either in combination with or in place of statin therapy depending on the patient's circumstances. The focus of this clinical perspective is sustainable lipoprotein goal achievement, which is important for cardiovascular risk reduction.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Recent narrative reviews on the management of SAMS found that further research is needed to close the knowledge gap [19].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Evolocumab and Clinical Outcomes in Patients with Cardiovascular Disease
Sabatine, M. S., Giugliano, R. P., Keech, A. C., Honarpour, N., Wiviott, S. D., Murphy, S. A., Kuder, J. F., Wang, H., Liu, T., Wasserman, S. M., et al. (2017) · New England Journal of Medicine · doi:10.1056/nejmoa1615664 · Cited by 6,138
Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes
Cannon, C. P., Blazing, M. A., Giugliano, R. P., McCagg, A., White, J. A., Theroux, P., Darius, H., Lewis, B. S., Ophuis, T. O., Jukema, J. W., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1410489 · Cited by 4,487
Ference, B. A., Ginsberg, H. N., Graham, I., Ray, K. K., Packard, C. J., Bruckert, E., Hegele, R. A., Krauss, R. M., Raal, F. J., Schunkert, H., et al. (2017) · European Heart Journal · doi:10.1093/eurheartj/ehx144 · Cited by 3,962
Helsinki Heart Study: Primary-Prevention Trial with Gemfibrozil in Middle-Aged Men with Dyslipidemia
Frick, M. H., Elo, O., Haapa, K., Heinonen, O. P., Heinsalmi, P., Helo, P., Huttunen, J. K., Kaitaniemi, P., Koskinen, P., Manninen, V., et al. (1987) · New England Journal of Medicine · doi:10.1056/nejm198711123172001 · Cited by 3,881
Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome
Schwartz, G. G., Steg, P. G., Szarek, M., Bhatt, D. L., Bittner, V. A., Diaz, R., Edelberg, J. M., Goodman, S. G., Hanotin, C., Harrington, R. A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1801174 · Cited by 3,634
Rubins, H. B., Robins, S. J., Collins, D., Fye, C. L., Anderson, J. W., Elam, M. B., Faas, F. H., Linares, E., Schaefer, E. J., Schectman, G., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199908053410604 · Cited by 3,439
Niacin in Patients with Low HDL Cholesterol Levels Receiving Intensive Statin Therapy
The AIM-HIGH Investigators (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1107579 · Cited by 2,911
Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.11.003 · Cited by 2,691
Research works printed but not linked: 1
- Lloyd-Jones, 2022, J. Am. Coll. Cardiol
Cited by
Sorted by citations
Virani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001168 · Cited by 1,598
Self-citationVirani, S. S., Newby, L. K., Arnold, S. V., Bittner, V., Brewer, L. C., Demeter, S. H., Dixon, D. L., Fearon, W. F., Hess, B., Johnson, H. M., et al. (2023) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.04.003 · Cited by 596
Self-citation2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia
Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., et al. (2026) · JACC · doi:10.1016/j.jacc.2025.11.016 · Cited by 304
Writing Committee Members, Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001423 · Cited by 122
Self-citationAdvances in statin adverse reactions and the potential mechanisms: A systematic review
Zeng, W., Deng, H., Luo, Y., Zhong, S., Huang, M., & Tomlinson, B. (2024) · Journal of Advanced Research · doi:10.1016/j.jare.2024.12.020 · Cited by 58
“…medication: Major alternative drugs include ezetimib e [110], PCSK9 mAb [111], bempedoic acid [111], inclisiran [112] and evinacumab for homozygous familial hypercholesterolemia [113]; （ III ） combination therapy:Ezetimibe or bempedoic acid + long-acting statin combination [107,110,114,115].”
First clinical experiences with inclisiran in a real-world setting
Mulder, J. W. C. M., Galema-Boers, A. M. H., & Roeters van Lennep, J. E. (2023) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2023.09.005 · Cited by 49
Cicero, A. F. G., Fogacci, F., Stoian, A. P., & Toth, P. P. (2023) · Nutrients · doi:10.3390/nu15102288 · Cited by 47
Safety of bempedoic acid in patients at high cardiovascular risk and with statin intolerance
Bays, H. E., Bloedon, L. T., Lin, G., Powell, H. A., Louie, M. J., Nicholls, S. J., Lincoff, A. M., & Nissen, S. E. (2023) · Journal of clinical lipidology · doi:10.1016/j.jacl.2023.10.011 · Cited by 38
Ahmad, Z., Agarwala, A., Cuchel, M., Duell, P. B., Hegele, R. A., Hudgins, L. C., Jamison, A., Kalra, D. K., Khera, A., Knowles, J. W., et al. (2026) · Journal of clinical lipidology · doi:10.1016/j.jacl.2026.01.011 · Cited by 37
Self-citationStatin associated muscle symptoms: An update and review
Dicken, W., Mehta, A., Karagiannis, A. D., Jain, V., Vavuranakis, M., Sperling, L. S., & Cassimatis, D. C. (2022) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2022.11.010 · Cited by 30
Lipid-Lowering Nutraceuticals for an Integrative Approach to Dyslipidemia
Cheung, B., Sikand, G., Dineen, E. H., Malik, S., & El-Farra, A. B. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12103414 · Cited by 28
“Coenzyme Q10 can be used in patients who develop SAMS [182].”
BackgroundInfluentialStatin associated muscle symptoms (SAMS): strategies for prevention, assessment and management
Iatan, I., Mancini, G. B. J., Yeoh, E., & Hegele, R. A. (2023) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2023.2215982 · Cited by 25
“Recent position statements include one from the National Lipid Association (NLA) [14].”
BackgroundInfluentialShah, M., Shrestha, K., Tseng, C., Goyal, A., Liewluck, T., & Gupta, L. (2024) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.15337 · Cited by 25
“4,61 64 The following algorithm has been suggested by the authors.”
Statins and non-alcoholic fatty liver disease: A concise review
Pereira, E. N. G. D. S., Franco, R. L. C., dos Santos, R. D. C., & Daliry, A. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2024.117805 · Cited by 21
The Role of the Clinical Psychologist in the Care of Adults With Cardiovascular Disease
Smolderen, K. G. E., Gillaspy, S. R., Evers, A. W. M., Kovacs, A. H., Massa-Carroll, I., Moons, P., & Mena‐Hurtado, C. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.100910 · Cited by 25
Self-citationLearnings from Implementation Strategies to Improve Lipid Management
Lan, N. S. R., Chen, R. T., Dwivedi, G., Watts, G. F., Nicholls, S. J., & Nelson, A. J. (2025) · Current Cardiology Reports · doi:10.1007/s11886-024-02174-8 · Cited by 20
Beavers, C. J., Pau, A. K., Glidden, D. V., Hyle, E. P., Kuriakose, S., Martin, S. S., McComsey, G. A., Thompson, M., Virani, S. S., & Baker, J. V. (2025) · Annals of Internal Medicine · doi:10.7326/annals-24-03564 · Cited by 20
The Role of Mitochondria in Statin-Induced Myopathy
Bell, G. M., Thoma, A., Hargreaves, I. P., & Lightfoot, A. P. (2024) · Drug Safety · doi:10.1007/s40264-024-01413-9 · Cited by 21
Bittner, V., Linnebur, S. A., Dixon, D. L., Forman, D. E., Green, A. R., Jacobson, T. A., Orkaby, A. R., Saseen, J. J., & Virani, S. S. (2025) · Journal of clinical lipidology · doi:10.1016/j.jacl.2024.09.005 · Cited by 20
Self-citationPatel, S. B., Belalcazar, L. M., Afreen, S., Balderas, R., Hegele, R. A., Karpe, F., Ponte-Negretti, C. I., & Rajpal, A. (2025) · Endocrine Practice · doi:10.1016/j.eprac.2025.07.014 · Cited by 21
Key genes and processes affected by atorvastatin treatment in mouse diaphragm muscle
Zakyrjanova, G. F., Matigorova, V. A., Kuznetsova, E. A., Анатольевна, Д. С., Tyapkina, O. V., Tsentsevitsky, A. N., Andreyanova, S. N., Odnoshivkina, J. G., Shigapova, R. R., Mukhamedshina, Y. O., et al. (2025) · Archives of Toxicology · doi:10.1007/s00204-025-04056-6 · Cited by 15
“Many circumstances like comorbid conditions (especially neuromuscular diseases), strenuous exercise and drugs (e.g., antiarrhythmics, antibiotics, and antiseizures) can be risk factors or aggravate SAMS (Alsolaihim and Baker 2020; Warden et al. 2023).”
Statin Intolerance: an Overview of US and International Guidance
Cheeley, M. K., Clegg, K., Lockridge, C., Schubert, T. J., & Jones, L. K. (2023) · Current Atherosclerosis Reports · doi:10.1007/s11883-023-01124-z · Cited by 15
Self-citationCordero, A., Olmo, R. F., Badimón, L., Santos‐Gallego, C. G., Castellano, J. M., Fácila, L., Rodríguez‐Mañero, M., Bonanad, C., Vilahur, G., Escribano, D., et al. (2023) · Journal of clinical lipidology · doi:10.1016/j.jacl.2023.08.006 · Cited by 16
Bittner, V., Linnebur, S. A., Dixon, D. L., Forman, D. E., Green, A. R., Jacobson, T. A., Orkaby, A. R., Saseen, J. J., & Virani, S. S. (2025) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19398 · Cited by 15
Self-citationStatins Ticagrelor and Rhabdomyolysis: A Coincidence or a Drug Interaction?
Patel, R., Sharma, J. B., & Rajput, S. (2024) · Journal of Lipid and Atherosclerosis · doi:10.12997/jla.2024.13.1.61 · Cited by 12
Jiang, Y., Wang, Y., Ma, S., Qian, L., Jing, Y., Chen, X., & Yang, J. (2025) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2024.1415668 · Cited by 16
Fogacci, F., Giovannini, M., Tocci, G., Imbalzano, E., Borghi, C., & Cicero, A. F. G. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13133741 · Cited by 10
“It is largely recognized that the most common symptoms resulting in statin intolerance or statin discontinuation are statin-associated muscle symptoms (SAMS, including myalgia, cramps, and asthenia), which have also been strongly associated with increased risk of CV events [7].”
BackgroundStatin-Associated Muscle Symptoms: Identification and Recommendations for Management
Maki, K. C., Kirkpatrick, C. F., Cheeley, M. K., & Jacobson, T. A. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01246-y · Cited by 11
“Muscle symptoms that are caused as a direct result of the pharmacological properties of statins are defined as “pharmacological SAMS” [ 18 ].”
InfluentialSelf-citationReasons for non-acceptance of statin therapy by patients at high cardiovascular risk
Xie, M., Martin, S. S., & Turchin, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-01930-2 · Cited by 10
“Mitigation strategies aimed at reducing patients’ concerns about statin adverse reactions, such as patient education and lower-intensity statin dosing regimens, could therefore play an important role in increasing patients’ acceptance of statin therapy 34 .”
A Critical Appraisal of Lipid Management in the Post-Statin Era
Spitz, J. A., Patel, J., Agarwala, A., Sharma, G. V., Mehta, A., Natarajan, P., Nasir, K., Morris, P. B., Blumenthal, R. S., & Shapiro, M. D. (2025) · JACC Advances · doi:10.1016/j.jacadv.2025.101823 · Cited by 12
Karalis, D. G. (2023) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000896 · Cited by 9
“Statin intolerance statin-associated muscle symptoms (SAMS) is an important cause of why clinicians do not intensify statin therapy and why patients discontinue their statin medication [10 && ].”
BackgroundGougeon, A., Aribi, I., Guernouche, S., Lega, J., Wright, J. M., Verstuyft, C., Lajoinie, A., Gueyffier, F., & Grenet, G. (2024) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.118624 · Cited by 9
Stürzebecher, P. E., Katzmann, J. L., Gouni-Berthold, I., Mateev, C., Frenzel, O., Schatz, U., Baessler, A., Köenig, W., Schirmer, S. H., Müller-Kozarez, I., et al. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.100953 · Cited by 7
“The management of patients with SI remains challenging [5 – 9].”
Safety and Efficacy of Achieving Very Low LDL Cholesterol Concentrations with PCSK9 Inhibitors
Balakrishna, A. M., Kaushik, S., Tandalam, S., Monther, N., Ponamgi, S., Alla, V. M., & Patil, S. M. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14134562 · Cited by 8
“Prior studies have shown that the true incidence of myopathy is very low with statin use, but it still leads to a high risk of drug discontinuation [39,40].”
Mehta, A., Dixon, D. L., Saeed, A., Kelly, M. S., Gulati, M., Shapiro, M. D., Sperling, L. S., & Virani, S. S. (2023) · Current Cardiology Reports · doi:10.1007/s11886-023-01861-2 · Cited by 7
Self-citationGavilán‐Carrera, B., Soriano‐Maldonado, A., Mediavilla-García, J. D., Lavie, C. J., & Vargas‐Hitos, J. A. (2023) · Pharmacological Research · doi:10.1016/j.phrs.2023.106962 · Cited by 8
“A summary of strategies proposed by different expert societies [12, 16] for SAMS prevention and management is presented in Table 1.”
InfluentialBreaking down statin myopathy: understanding the self-limited and autoimmune subtypes
Wright, J., & Christopher‐Stine, L. (2024) · Rheumatology · doi:10.1093/rheumatology/keae284 · Cited by 7
Sun, B., Yew, P. Y., Chi, C., Song, M., Loth, M., Zhang, R., & Straka, R. J. (2023) · JAMIA Open · doi:10.1093/jamiaopen/ooad087 · Cited by 6
“21 As shown in Table 3, the prevalence or values of several baseline factors were statistically different between SAMS case ( N ¼ 329) and control ( N ¼ 16 560) cohorts.”
BackgroundMethodResultLiu, H.-H., Li, S., & Li, J. (2025) · Drugs · doi:10.1007/s40265-025-02167-z · Cited by 7
Alqasrawi, M. N., Al-Mahayri, Z. N., Khasawneh, L. Q., Albawa’neh, A. S., Dabaghie, L., Altoum, S. M., Hamza, D., Aburuz, S., Misra, V., Jamil, G., et al. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1656520 · Cited by 6
Muscle-Related Adverse Events Associated With PCSK9 Inhibitors in a Veteran Population
Cencetti, J. (2023) · Federal Practitioner · doi:10.12788/fp.0357 · Cited by 5
Modern algorithms for statin therapy
Susekov, A. V. (2023) · Russian Journal of Cardiology · doi:10.15829/1560-4071-2023-5594 · Cited by 6
Lipid-lowering approaches to manage statin-intolerant patients
Ruscica, M., Bertoletti, A., Gobbi, C., Sirtori, C. R., Carugo, S., & Corsini, A. (2024) · European Heart Journal Supplements · doi:10.1093/eurheartjsupp/suae007 · Cited by 6
“7 Considering that the decision on which drug to use in statin-intolerant patients is often based on patients’ preference, tolerability of self-administered injections, and affordability, the aim of the present narrative review is to discuss the most suitable lipid-lowering approaches to manage…”
BackgroundStatin-Intolerant Patients Exhibit Diminished Muscle Strength Regardless of Lipid-Lowering Therapy
Vinci, P., Girolamo, F. G. D., Pellicori, F., Panizon, E., Pirulli, A., Tosoni, L. M., Altamura, N., Rizzo, S., Perin, A., Fiotti, N., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14041221 · Cited by 5
“…muscle symptoms (SAMS), a clinically heterogeneous condition which encompasses symmetrical muscle pain, weakness, and fatigue; frequently appearing early after the beginning of statin treatment [1], with occasional rhabdomyolysis, and with or without changes in circulating creatine kinase (CK) [2].”
Diagnosis and Management of Statin-Associated Muscle Symptoms
Cha, J., & Hong, S. J. (2025) · Korean Circulation Journal · doi:10.4070/kcj.2025.0285 · Cited by 5
“17)29)”
InfluentialTherapeutic Applications of Natural Products in Biomedicine and Pharmacotherapy
Sah, A. K., Patel, S., Kumar, D. R. P., Mishra, P. S., Mishra, R., Умарович, А. И., Elshaikh, R. H., Agarwal, S., Bhardwaj, A., Choudhary, R. K., et al. (2026) · Life · doi:10.3390/life16060873 · Cited by 5
“The natural product lovastatin led to the discovery of synthetic statins in which modifications to the side chain and ring substitutions improved binding affinity to HMG-CoA reductase and improved lipid-lowering efficacy [87,88].”
Clinical Considerations for Healthcare Provider-Administered Lipid-Lowering Medications
Bertolet, B. D., Cabral, K. P., Sullenberger, L. E., McAlister, J., Sandroni, T., & Patel, D. S. (2024) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-024-00665-1 · Cited by 4
“Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance, and pharmacological SAMS are estimated to occur in approximately 1–2% of patients [18].”
BackgroundStatin‑associated myasthenia gravis: a real-world retrospective and pharmacovigilance study
Lu, Y., Huang, D., Shen, J., Yang, M., & Wang, S. (2025) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2025.2467183 · Cited by 4
“[37].”
Talasaz, A. H., Cuomo, M., & Maurer, M. S. (2025) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.08.015 · Cited by 3
Pavanello, C., Cincotto, G., Mombelli, G. G., Castiglione, S., Santolamazza, C., Calabresi, L., Sirtori, C. R., & Albertí, A. (2025) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.09.033 · Cited by 3
Gergely, T. G., Brenner, G. B., Nagy, R. N., Sayour, N. V., Makkos, A., Kovácsházi, C., Tian, H., Schulz, R., Giricz, Z., Görbe, A., et al. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms24021585 · Cited by 3
“1% of patients [8], mainly in the form of skeletal-muscle-related adverse events [9].”
BackgroundPeyrel, P., Mauriège, P., Frenette, J., Laflamme, N., Greffard, K., Dufresne, S. S., Huth, C., Bergeron, J., & Joanisse, D. R. (2023) · Journal of clinical lipidology · doi:10.1016/j.jacl.2023.12.002 · Cited by 3
Zhao, A., Guo, D., Zhu, M., Gao, A., Li, P., & Fu, A. (2024) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-024-03662-0 · Cited by 3
“The incidence of SAMS was estimated at 1–2% by National Lipid Association [28], while serious muscle injury, including rhabdomyolysis, was estimated at under 0.1% in general patient population by the American Heart Association [4].”
InfluentialFamilial hypercholesterolaemia and emerging therapeutics
Farias, F. I., Kim, S. M., & Shapiro, M. D. (2023) · Heart · doi:10.1136/heartjnl-2022-321917 · Cited by 3
Grant, J. K., & Orringer, C. E. (2024) · Journal of clinical lipidology · doi:10.1016/j.jacl.2024.07.007 · Cited by 3
Sun, B., Yew, P. Y., Chi, C., Song, M., Loth, M., Liang, Y., Zhang, R., & Straka, R. J. (2024) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.3208 · Cited by 2
The effects of statins on mitochondria – the current state of knowledge
Belczyk, M., Knapik-Czajka, M. E., Gawędzka, A., & Drąg, J. (2025) · Farmacja Polska · doi:10.32383/farmpol/197743 · Cited by 2
Bempedoic Acid: A Review in Cardiovascular Risk Reduction in Statin-Intolerant Patients
McGuigan, A., & Blair, H. A. (2025) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-024-00714-9 · Cited by 4
“Thus, not all patients are able or willing to receive statins (i.e. they are ‘statin-intolerant’), which limits their ability to achieve target blood LDL-C levels, thereby increasing CV risk [5, 7].”
Update on statin-associated myopathy symptoms in the view of new clinical management strategies
Musumeci, O., & Drago, S. F. A. (2025) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001405 · Cited by 2
Effects of nonsense genetic variants on OATP1B1 expression and transport activity in vitro
Kiander, W., Rashidpour, H., Gynther, M., Vellonen, K., Neuvonen, M., Vesalainen, L., Huttunen, K. M., Niemi, M., & Kidron, H. (2025) · European Journal of Pharmaceutical Sciences · doi:10.1016/j.ejps.2025.107322 · Cited by 2
Lee, K., Kang, M., Lee, E. J., Oh, J., Han, N., Lee, J.-Y., Lee, J.-Y., Lee, S. J., Debette, S., Paré, G., et al. (2026) · Journal of Stroke · doi:10.5853/jos.2025.04595 · Cited by 2
“70,71 The most well-established pharmacogenomic association involves the SLCO1B1 gene, which encodes the hepatic uptake transporter OATP1B1 .”
Corsetti, G., & Pasini, E. (2026) · Nutrients · doi:10.3390/nu18050722 · Cited by 3
“Globally, data from clinical trials and observational studies indicate that 20–25% of patients discontinue statins within 1–2 years, and that 5–10% experience true intolerance [18–20].”
Louro, R., Melo, R. G. E., Ruivo, J., Almeida, A. G., Pinto, F. J., & Caldeira, D. (2023) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2023.2274502 · Cited by 3
Brobst, M., Chapet, N., Benchalkha, D., Bourgeois, E., Herman, F., Molinari, N., Leclercq, F., Pasquié, J., Breuker, C., Sultan, A., et al. (2024) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2024.10.332 · Cited by 2
The Role of Statins in Managing Chronic Kidney Disease: A Comprehensive Review
Toshniwal, S. S., Parepalli, A., Loya, A., Toshniwal, T., Kumar, S., & Acharya, S. (2025) · International journal of Nutrition Pharmacology Neurological Diseases · doi:10.4103/ijnpnd.ijnpnd_146_24 · Cited by 2
Beyond the Generalized Weakness: A Rare Case of Statin-Induced Immune-Mediated Necrotizing Myopathy
Sakai, L., Kazbour, H., & Huang, J. G. (2025) · Journal of Investigative Medicine High Impact Case Reports · doi:10.1177/23247096251344727 · Cited by 3
The Use of Pharmacogenomics in Cardiovascular Care
Spahn, C., Walker, T. K., Byurat, S., & Palaniappan, L. P. (2025) · Nursing Clinics of North America · doi:10.1016/j.cnur.2024.12.007 · Cited by 1
Qi, G., Rao, A. M., Tariq, S., & Ledesma, L. D. (2025) · Cureus · doi:10.7759/cureus.86246 · Cited by 1
“The combination of rosuvastatin and fenofibrate likely contributed to the recurrence of rhabdomyolysis in addition to myositis, as both agents possess independent myotoxic potential and share metabolic pathways such as glucuronidation, thereby amplifying toxicity risk [1,2].”
Zeeshan, M., Raza, A., Waseem, A., Sadia, S., Mushtaq, M. R., Siddiqui, S., Shabbir, H., & Sarker, P. (2025) · Cureus · doi:10.7759/cureus.92705 · Cited by 1
“SAMS include a wide variety of muscular complaints and contain, but are not limited to, myalgia, muscle cramps, weakness, and, in extreme cases, rhabdomyolysis [2].”
Myerson, M. L., Warden, B. A., Saseen, J. J., & Paparodis, R. D. (2025) · Journal of the American Heart Association · doi:10.1161/jaha.125.044134 · Cited by 1
“45 Finally, data in the lipid-lowering sector demonstrate that there is a wide interpatient variability in lipid response and this needs to be verified with on-treatment lipid panel checks.”
Self-citationWarden, B. A., & Duell, P. B. (2025) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.10.065 · Cited by 1
Self-citationZuin, M., & Bilato, C. (2025) · Internal and Emergency Medicine · doi:10.1007/s11739-025-04234-5 · Cited by 2
Guo, P., Yu, X., Wei, X., Xiong, X., & Jiang, J. (2025) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000001785 · Cited by 1
“5,6 Moreover, even when LDL-C targets are achieved, a signi fi cant residual risk remains; 60% – 80% of cardiovascular events still occur.”
Silverman-Lloyd, L. G., Sathiyakumar, V., Huynh, P. P., Chang, B., Pletcher, M. J., Halpern, J., Ivey, S. L., & Martin, S. S. (2026) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.12.026 · Cited by 1
Zárate-Correa, L. C., García-Peña, Á. A., Kaiser, S. E., Aguilar-Salinas, C. A., Méndez-Castillo, M., Mehta, R., Valério, C. M., Moreira, R. O., Mancillas‐Adame, L. G., Canto, J. A. C., et al. (2026) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2026.120783 · Cited by 2
Regarding: Myasthenia gravis following the initiation of statin therapy
Zeng, S., & Shi, Z. (2026) · Journal of Internal Medicine · doi:10.1111/joim.70122 · Cited by 1
“The National Lipid Association estimates that muscle symptoms related to statin use happen in about 10% of users, but only 1%–2% are truly caused by the medication [2].”
Somers, T., Allard, N. A. E., Siddiqi, S., Janssen, M. C. M., Hopman, M. T. E., Morshuis, W. J., Rüssel, F. G. M., Timmers, S., & Schirris, T. J. J. (2023) · Scientific Reports · doi:10.1038/s41598-023-36741-w · Cited by 1
Гиполипидемическая терапия в особых ситуациях
Арутюнов, Г. П., Владиславович, Е. М., Alieva, A. S., Иосифович, Ш. И., Orlova, Y. A., Koziolova, N. A., Тарловская, Е. И., Григорьева, Н. Ю., & Chesnikova, A. I. (2024) · Атеросклероз и дислипидемии · doi:10.34687/2219-8202.jad.2024.03.0008 · Cited by 1
Tajudin, N. H. M., Fahrni, M. L., Ghani, R. A., Awang, M. H., Chopra, H., & Alkhoshaiban, A. S. (2024) · Journal of Pharmacology and Pharmacotherapeutics · doi:10.1177/0976500x241268964 · Cited by 1
“10 The SAMS-CI does not give a definitive association, instead, it categorizes the association into: “unlikely,” “possibly,” and “probably.””
Rationale for Increasing Doses of Statins in Everyday Clinical Practice
Susekov, A. V. (2024) · Kardiologiia · doi:10.18087/cardio.2024.8.n2709 · Cited by 1
Lipidology: The time is now for specialty recognition
Willard, K.-E., Wilson, D. P., Jackson, E. J., Kirkpatrick, C. F., Cheeley, M. K., & Kalra, D. K. (2024) · Journal of clinical lipidology · doi:10.1016/j.jacl.2024.11.002 · Cited by 1
Kulasingam, A., Laustsen, S., Busk, M., Sand, N. P. R., Winther, S., Kragholm, K. H., Hammid, O., Pedersen, K. B., Vedsted, P., Kanstrup, H., et al. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.04.002 · Cited by 1
Landmesser, U., Laufs, U., Schatz, U., Winzer, E. B., Nowak, B., Kassner, U., Gouni‐Berthold, I., Esteban, A., Lubyayi, L., Krueger, A., et al. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.05.014 · Cited by 1
When PCSK9 Inhibitors Don’t Save the Day
Soffer, D. E. (2025) · JACC Case Reports · doi:10.1016/j.jaccas.2025.103759 · Cited by 1
Maki, K. C., & Duell, P. B. (2026) · Journal of clinical lipidology · doi:10.1016/j.jacl.2026.02.022 · Cited by 1
Self-citationAebi, P. S., Villoz, F., Bührer, J., Lyko, C., Abolhassani, N., Del Giovane, C., Gencer, B., Rodondi, N., & Blum, M. R. (2025) · PLOS One · doi:10.1371/journal.pone.0338575
“Recent narrative reviews on the management of SAMS found that further research is needed to close the knowledge gap [19].”
Sun, B., Yew, P. Y., Chi, C., Song, M., Loth, M., Liang, Y., Zhang, R., & Straka, R. J. (2023) · medRxiv · doi:10.1101/2023.08.10.23293939
“As a result, the reported prevalence of SAMS can range from <1% in clinical trials to up to 25% from observational studies.(3) Previously, our research team accomplished the development of a PSAMS phenotyping algorithm based on the University of Minnesota (UMN) Fairview EHR system.”
BackgroundInfluentialStatine: Nebenwirkungen – alternative Therapieoptionen
Makhmudova, U., & Weingärtner, O. (2024) · Die Kardiologie · doi:10.1007/s12181-024-00669-w · Cited by 1
Putri, W. C. C., Sari, M., Wahyuni, F. A., & Suryani, N. (2024) · Acta Holistica Pharmaciana. · doi:10.62857/ahp.v6i1.164
Lee, M., & Safri, A. (2024) · ADCES in Practice · doi:10.1177/2633559x241280315
Statins in the practice of an internal medicine specialist: A review
Susekov, A. V. (2024) · Consilium Medicum · doi:10.26442/20751753.2024.10.202995
Demystifying the nuances of the lipid patient: a guide for primary care providers
Myerson, M. L., Gillett, K., O’Hara, J., Potter, R., & SKOLNIK, N. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.101070
“…for nonstatin causes, statin discontinuation is reasonable until symptoms resolve, followed by rechallenge with a lower dose, an alternative statin, alternative dosing regimen (i.e., a statin with a longer half-life [atorvastatin or rosuvastatin] on non-daily regimen), or use of a nonstatin [4,70].”
Dietary and nutrient influences on statin-associated muscle symptoms: mechanisms and insights
Ahmadi, A. R., Baghdadi, G., Aziznezhad, H., & Rahimlou, M. (2025) · Academia Nutrition and Dietetics · doi:10.20935/acadnutr7875
Dziewierz, A., Bobrowska, B., Streb, W., Pelliccia, F., Bartuś, S., & Rajtar-Salwa, R. (2025) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2025.2570839
“Management strategies for SAMS include temporarily discontinuing the statin, re-challenging with the same or a different statin at a lower dose, switching to a more hydrophilic statin (e.g. pravastatin, rosuvastatin), or alternate-day dosing [35].”
InfluentialHofmann, M., Berger, T., & Weiss, P. (2022) · Specialty journal of Pharmacognosy Phytochemistry and Biotechnology · doi:10.51847/wyrmvx9kyk
Pharmacogenomics and Cardiovascular Care for Older Adults
Rowe, C., Delgado, E., Lee, Y. M., Bright, D. R., & Roman, Y. M. (2025) · Springer eBooks · doi:10.1007/978-3-032-10653-7_5
Grant, J. K., Selvam, P. V., Koester, M., Leucker, T. M., & Barth, A. S. (2026) · Journal of clinical lipidology · doi:10.1016/j.jacl.2025.10.002
Chalès, G., Robin, F., & Guggenbuhl, P. (2026) · EMC - Appareil locomoteur · doi:10.1016/s0246-0521(25)47869-3
Metadata
- Authors
- Warden, B. A., Guyton, J. R., Kovacs, A. C., Durham, J. A., Jones, L. K., Dixon, D. L., Jacobson, T. A., & Duell, P. B.
- Affiliations
- Oregon Health & Science University (US)
- Duke Medical Center (US)
- Virginia Commonwealth University (US)
- Emory University (US)
- Corresponding author
- Warden, Bruce A.
- Guyton, John R.
- Kovacs, Adrienne C.
- Durham, Jessica A.
- Jones, Laney K.
- Dixon, Dave L.
- Jacobson, Terry A.
- Duell, P. Barton
- Venue
- Journal of Clinical Lipidology
- Publisher
- Elsevier BV
- Published
- 2023-01
- Volume
- 17
- Issue
- 1
- Pages
- 19-39
- ISSN
- 1876-4789 (ISSN-L)
- 1933-2874
- OpenAlex
- W4295221059
- Cited by
- 111
- References
- 82
- Citations by year
- 2026: 24 · 2025: 40 · 2024: 24 · 2023: 21
- FWCI
- 20.88
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of clinical lipidology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- statin-associated muscle symptoms, statin intolerance, statin discontinuation, cardiovascular risk, medication adherence, lifestyle intervention, statin dose reduction, non-statin therapy, cardiovascular risk reduction
- MeSH terms
- Humans, Lipids, Muscles, Muscular Diseases, Risk Factors, Hydroxymethylglutaryl-CoA Reductase Inhibitors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
