What proportion of symptomatic side effects in patients taking statins are genuinely caused by the drug? Systematic review of randomized placebo-controlled trials to aid individual patient choice
Abstract
OBJECTIVE: Discussions about statin efficacy in cardiovascular prevention are always based on data from blinded randomized controlled trials (RCTs) comparing statin to placebo; however, discussion of side effects is not. Clinicians often assume symptoms occurring with statins are caused by statins, encouraging discontinuation. We test this assumption and calculate an evidence-based estimate of the probability of a symptom being genuinely attributable to the statin itself. METHODS: We identified RCTs comparing statin to placebo for cardiovascular prevention that reported side effects separately in the two arms. RESULTS: Among 14 primary prevention trials (46,262 participants), statin therapy increased diabetes by absolute risk of 0.5% (95% CI 0.1-1%, p = 0.012), meanwhile reducing death by a similar extent: -0.5% (-0.9 to -0.2%, p = 0.003). In the 15 secondary prevention RCTs (37,618 participants), statins decreased death by 1.4% (-2.1 to -0.7%, p < 0.001). There were no other statin-attributable symptoms, although asymptomatic liver transaminase elevation was 0.4% more frequent with statins across all trials. Serious adverse events and withdrawals were similar in both arms. CONCLUSIONS: Only a small minority of symptoms reported on statins are genuinely due to the statins: almost all would occur just as frequently on placebo. Only development of new-onset diabetes mellitus was significantly higher on statins than placebo; nevertheless only 1 in 5 of new cases were actually caused by statins. Higher statin doses produce a detectable effect, but even still the proportion attributable to statins is variable: for asymptomatic liver enzyme elevation, the majority are attributable to the higher dose; in contrast for muscle aches, the majority are not.
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
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?
A meta-analysis of individual participant data from randomized trials showed that statins have no significant effect on cancer, at least over about 5 years.
“For cancer, a meta-analysis of IPD from randomized trials has shown that statins do not have any significant effect on cancer, at least over a period of ∼5 years [223].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [223]
Reported rates of muscle symptoms are invariably lower in blinded RCTs when compared with those in registries and observational studies, with myalgia rates similar in subjects on statin or placebo.
“As indicated above, reported rates of muscle symptoms are invariably lower in blinded RCTs when compared with those in registries and observational studies, with myalgia rates similar in subjects on statin or placebo.2–4,20,21”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Cholesterol Treatment Trialists' (CTT) Collaboration (2010) · The Lancet · doi:10.1016/s0140-6736(10)61350-5 · Cited by 6,550 · see citing works
Intensive versus Moderate Lipid Lowering with Statins after Acute Coronary Syndromes
Cannon, C. P., Braunwald, E., McCabe, C. H., Rader, D. J., Rouleau, J. L., Belder, R., Joyal, S. V., Hill, K. A., Pfeffer, M. A., & Skene, A. M. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040583 · Cited by 4,938 · see citing works
Intensive Lipid Lowering with Atorvastatin in Patients with Stable Coronary Disease
LaRosa, J. C., Grundy, S. M., Waters, D. D., Shear, C., Barter, P., Fruchart, J.-C., Gotto, A. M., Greten, H., Kastelein, J. J. P., Shepherd, J., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa050461 · Cited by 3,489 · see citing works
External validity of randomised controlled trials: “To whom do the results of this trial apply?”
Rothwell, P. M. (2005) · The Lancet · doi:10.1016/s0140-6736(04)17670-8 · Cited by 2,544 · see citing works
Statins for the primary prevention of cardiovascular disease
Taylor, F., Huffman, M. D., Macedo, A. F., Moore, T. H., Burke, M., Davey Smith, G., Ward, K., Ebrahim, S., & Gay, H. C. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004816.pub5 · Cited by 1,934 · see citing works
Preiss, D. (2011) · JAMA · doi:10.1001/jama.2011.860 · Cited by 1,390 · see citing works
de Lemos, J. A., Blazing, M. A., Wiviott, S. D., Lewis, E. F., Fox, K. A. A., White, H. D., Rouleau, J.-L., Pedersen, T. R., Gardner, L. H., Mukherjee, R., et al. (2004) · JAMA · doi:10.1001/jama.292.11.1307 · Cited by 1,333 · see citing works
Effect of pravastatin on outcomes after cardiac transplantation
Kobashigawa, J. A., Katznelson, S., Laks, H., Johnson, J. A., Yeatman, L., Wang, X. M., Chia, D., Terasaki, P. I., Sabad, A., Cogert, G. A., et al. (1995) · New England Journal of Medicine · doi:10.1056/nejm199509073331003 · Cited by 1,301 · see citing works
Bruckert, E., Hayem, G., Dejager, S., Yau, C., & Bégaud, B. (2005) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-005-5686-z · Cited by 1,226 · see citing works
Holdaas, H., Fellström, B., Jardine, A. G., Holme, I., Nyberg, G., Fauchald, P., Grönhagen-Riska, C., Madsen, S., Neumayer, H.-H., Cole, E., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)13638-0 · Cited by 919 · see citing works
Ridker, P. M., Pradhan, A., MacFadyen, J. G., Libby, P., & Glynn, R. J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61190-8 · Cited by 816 · see citing works
Nonspecific medication side effects and the nocebo phenomenon
Barsky, A. J. (2002) · JAMA · doi:10.1001/jama.287.5.622 · Cited by 784 · see citing works
Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group (2010) · The Lancet · doi:10.1016/s0140-6736(10)60310-8 · Cited by 558 · see citing works
Hippisley‐Cox, J., & Coupland, C. A. C. (2010) · BMJ · doi:10.1136/bmj.c2197 · Cited by 511 · see citing works
Risks Associated With Statin Therapy: A Systematic Overview of Randomized Clinical Trials
Kashani, A., Phillips, C. O., Foody, J. M., Wang, Y., Mangalmurti, S., Ko, D. T., & Krumholz, H. M. (2006) · Circulation · doi:10.1161/circulationaha.106.624890 · Cited by 474 · see citing works
Ray, K. K. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2010.182 · Cited by 446 · see citing works
Risk of incident diabetes among patients treated with statins: population based study
Carter, A. A., Gomes, T., Camacho, X., Juurlink, D. N., Shah, B. R., & Mamdani, M. M. (2013) · BMJ · doi:10.1136/bmj.f2610 · Cited by 404 · see citing works
Andrade, S. E., Walker, A. M., Gottlieb, L. K., Hollenberg, N., Testa, M. A., Saperia, G., & Platt, R. (1995) · New England Journal of Medicine · doi:10.1056/nejm199504273321703 · Cited by 391 · see citing works
Primary Prevention of Cardiovascular Diseases With Statin Therapy
Thavendiranathan, P. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.21.2307 · Cited by 349 · see citing works
Predictors of New-Onset Diabetes in Patients Treated With Atorvastatin
Waters, D. D., Ho, J. E., DeMicco, D. A., Breazna, A., Arsenault, B. J., Wun, C.-C., Kastelein, J. J., Colhoun, H., & Barter, P. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.10.047 · Cited by 333 · see citing works
Nocebo effects, patient–clinician communication, and therapeutic outcomes
Colloca, L., & Finniss, D. (2012) · JAMA · doi:10.1001/jama.2012.115 · Cited by 326 · see citing works
High-dose statins and skeletal muscle metabolism in humans: a randomized, controlled trial
PAIVA, H., THELEN, K., COSTER, R., SMET, J., PAEPE, B., MATTILA, K., LAAKSO, J., LEHTIMAKI, T., VONBERGMANN, K., & LUTJOHANN, D. (2005) · Clinical Pharmacology & Therapeutics · doi:10.1016/j.clpt.2005.03.006 · Cited by 308 · see citing works
Statin-related adverse events: A meta-analysis
Silva, M. A., Swanson, A. C., Gandhi, P. J., & Tataronis, G. R. (2006) · Clinical Therapeutics · doi:10.1016/j.clinthera.2006.01.005 · Cited by 275 · see citing works
Smeeth, L. L., Douglas, I., Hall, A. J., Hubbard, R., & Evans, S. J. W. (2008) · British Journal of Clinical Pharmacology · doi:10.1111/j.1365-2125.2008.03308.x · Cited by 234 · see citing works
Naci, H., Brugts, J. J., Fleurence, R., Tsoi, B., Toor, H., & Ades, A. (2013) · European Journal of Preventive Cardiology · doi:10.1177/2047487313480435 · Cited by 202 · see citing works
Nichols, G. A., & Koro, C. E. (2007) · Clinical Therapeutics · doi:10.1016/j.clinthera.2007.08.022 · Cited by 173 · see citing works
Calderon, R. M., Cubeddu, L. X., Goldberg, R. B., & Schiff, E. R. (2010) · Mayo Clinic Proceedings · doi:10.4065/mcp.2009.0365 · Cited by 164 · see citing works
Rosenzweig, P., Brohier, S., & Zipfel, A. (1993) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.1993.190 · Cited by 130 · see citing works
Barron, A., Zaman, N., Cole, G. D., Wensel, R., Okonko, D. O., & Francis, D. P. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.05.068 · Cited by 116 · see citing works
Self-citationMRC/BHF Heart Protection Study Collaborative Group (2009) · BMC Clinical Pharmacology · doi:10.1186/1472-6904-9-6 · Cited by 70 · see citing works
Galtier, F., Mura, T., de Mauverger, É. R., Chevassus, H., Farret, A., Gagnol, J., Costa, F., Dupuy, A., Petit, P., Cristol, J., et al. (2012) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2012.06.020 · Cited by 55 · see citing works
Stegmayr, B. G., Brännström, M., Bucht, S., Crougneau, V., Dimény, E., Ekspong, A., Eriksson, M., Granroth, B., Gröntoft, K., Hadimeri, H., et al. (2005) · Scandinavian Journal of Urology and Nephrology · doi:10.1080/00365590500329304 · Cited by 47 · see citing works
Efficacy and safety of fluvastatin therapy for hypercholesterolemia after heart transplantation
O'Rourke, B. P., Barbir, M., Mitchell, A. G., Yacoub, M. H., & Banner, N. R. (2004) · International Journal of Cardiology · doi:10.1016/j.ijcard.2003.04.009 · Cited by 26 · see citing works
Flagged first, then by citations
Research works printed but not linked: 4
- Ray KK, Seshasai SR, Erqou S, et al. Statins and all- cause mortality in high-risk primary prevention. Arch Intern Med 2010; 170: 1024-1031.
- Naci H, Brugts JJ, Fleurence R, et al. Comparative bene- fits of statins in the primary and secondary prevention of major coronary events and all-cause mortality. Eur J Prev Cardiol 2013; 20: 641-657.
- Pedersen TR, Faergeman O, Kastelein JJ, et al. High- dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study. JAMA 2005; 294: 2437-2445.
- SEARCH Collaborative Group. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12 064 survivors of myocardial infarction. Lancet 2010; 376: 1658-1669.
Cited by
Sorted by citations
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961 · see citing works
Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854 · see citing works
Interpretation of the evidence for the efficacy and safety of statin therapy
Collins, R., Reith, C., Emberson, J., Armitage, J., Baigent, C., Blackwell, L., Blumenthal, R., Danesh, J., Smith, G. D., DeMets, D., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31357-5 · Cited by 1,857 · see citing works
Stroes, E. S., Thompson, P. D., Corsini, A., Vladutiu, G. D., Raal, F. J., Ray, K. K., Roden, M., Stein, E., Tokgözoğlu, L., Nordestgaard, B. G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv043 · Cited by 1,443 · see citing works
Newman, C. B., Preiss, D., Tobert, J. A., Jacobson, T. A., Page, R. L., II, Goldstein, L. B., Chin, C. C., Tannock, L. R., Miller, M. J., Raghuveer, G., et al. (2019) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atv.0000000000000073 · Cited by 760 · see citing works
Kopin, L., & Lowenstein, C. J. (2017) · Annals of Internal Medicine · doi:10.7326/aitc201712050 · Cited by 589 · see citing works
Statins for Prevention of Cardiovascular Disease in Adults
Chou, R., Dana, T., Blazina, I., Daeges, M., & Jeanne, T. L. (2016) · JAMA · doi:10.1001/jama.2015.15629 · Cited by 570 · see citing works
Banach, M., Rizzo, M., Toth, P. P., Farnier, M., Davidson, M. H., Al‐Rasadi, K., Aronow, W. S., Athyros, V. G., Djuric, D. M., Владиславович, Е. М., et al. (2015) · Archives of Medical Science · doi:10.5114/aoms.2015.49807 · Cited by 381 · see citing works
Petrie, K. J., & Rief, W. (2019) · Annual Review of Psychology · doi:10.1146/annurev-psych-010418-102907 · Cited by 309 · see citing works
Chou, R., Cantor, A., Dana, T., Wagner, J., Ahmed, A. Y., Fu, R., & Ferencik, M. (2022) · JAMA · doi:10.1001/jama.2022.12138 · Cited by 287 · see citing works
N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects
Wood, F. A., Howard, J. P., Finegold, J. A., Nowbar, A. N., Thompson, D. M., Arnold, A. D., Rajkumar, C. A., Connolly, S., Cegla, J., Stride, C., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2031173 · Cited by 274 · see citing works
Self-citationMancini, G. B. J., Baker, S. K., Bergeron, J., FITCHETT, D. H., Frohlich, J. J., Genest, J. J., Gupta, M., Hegele, R. A., Ng, D. S., Pearson, G. J., et al. (2016) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2016.01.003 · Cited by 253 · see citing works
Atherosclerotic cardiovascular disease prevention in rheumatoid arthritis
Semb, A. G., Ikdahl, E., Wibetoe, G., Crowson, C. S., & Rollefstad, S. (2020) · Nature Reviews Rheumatology · doi:10.1038/s41584-020-0428-y · Cited by 216 · see citing works
Side Effect Patterns in a Crossover Trial of Statin, Placebo, and No Treatment
Howard, J. P., Wood, F. A., Finegold, J. A., Nowbar, A. N., Thompson, D. M., Arnold, A. D., Rajkumar, C. A., Connolly, S., Cegla, J., Stride, C., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.07.022 · Cited by 198 · see citing works
Self-citationNon-cardiovascular effects associated with statins
Desai, C. S., Martin, S. S., & Blumenthal, R. S. (2014) · BMJ · doi:10.1136/bmj.g3743 · Cited by 172 · see citing works
Arvanitis, M., & Lowenstein, C. J. (2023) · Annals of Internal Medicine · doi:10.7326/aitc202306200 · Cited by 168 · see citing works
Banach, M., Rizzo, M., Toth, P. P., Farnier, M., Davidson, M. H., Al-Rasadi, K., Aronow, W. S., Athyros, V., Djuric, D. M., Ezhov, M. V., et al. (2015) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2015.1039980 · Cited by 162 · see citing works
Hope, H. F., Binkley, G. M., Fenton, S. A. M., Kitas, G. D., Verstappen, S. M. M., & Symmons, D. P. M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0201196 · Cited by 144 · see citing works
Downs, J. R., & O’Malley, P. G. (2015) · Annals of Internal Medicine · doi:10.7326/m15-0840 · Cited by 136 · see citing works
Simvastatin and vitamin D for migraine prevention: A randomized, controlled trial
Buettner, C., Nir, R., Bertisch, S. M., Bernstein, C. A., Schain, A. J., Mittleman, M. A., & Burstein, R. (2015) · Annals of Neurology · doi:10.1002/ana.24534 · Cited by 135 · see citing works
The nocebo effect in the context of statin intolerance
Tobert, J. A., & Newman, C. B. (2016) · Journal of clinical lipidology · doi:10.1016/j.jacl.2016.05.002 · Cited by 125 · see citing works
Penson, P. E., Mancini, G. B. J., Toth, P. P., Martin, S. S., Watts, G. F., Sahebkar, A., Mikhailidis, D. P., Banach, M., & on behalf of Lipid and Blood Pressure Meta‐Analysis Collaboration (LBPMC) Group & International Lipid Expert Panel (ILEP) (2018) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.12344 · Cited by 110 · see citing works
Novel and future lipid-modulating therapies for the prevention of cardiovascular disease
Brandts, J., & Ray, K. K. (2023) · Nature Reviews Cardiology · doi:10.1038/s41569-023-00860-8 · Cited by 107 · see citing works
Mills, S., Yang, B. K., Smith, G., Stanton, C., & Ross, R. P. (2023) · Gut Microbes · doi:10.1080/19490976.2023.2186098 · Cited by 106 · see citing works
Muscle- and skeletal-related side-effects of statins: tip of the iceberg?
Auer, J., Sinzinger, H. F., Franklin, B., & Berent, R. (2014) · European Journal of Preventive Cardiology · doi:10.1177/2047487314550804 · Cited by 85 · see citing works
Maierean, S. M., Șerban, M.-C., Sahebkar, A., Ursoniu, S., Serban, A., Penson, P. E., & Banach, M. (2017) · Journal of clinical lipidology · doi:10.1016/j.jacl.2017.08.004 · Cited by 84 · see citing works
Patient-Accessible Tool for Shared Decision Making in Cardiovascular Primary Prevention
Fontana, M., Asaria, P., Moraldo, M., Finegold, J. A., Hassanally, K., Manisty, C., & Francis, D. P. (2014) · Circulation · doi:10.1161/circulationaha.113.007595 · Cited by 81 · see citing works
Self-citationHobbs, F. R., Banach, M., Mikhailidis, D. P., Malhotra, A., & Capewell, S. (2016) · BMC Medicine · doi:10.1186/s12916-016-0550-5 · Cited by 76 · see citing works
The Influence of Side Effect Information Framing on Nocebo Effects
Faasse, K., Huynh, A., Pearson, S., Geers, A. L., Helfer, S. G., & Colagiuri, B. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay071 · Cited by 72 · see citing works
Muscle Toxicity of Drugs: When Drugs Turn Physiology into Pathophysiology
Janssen, L., Allard, N. A. E., Saris, C. G. J., Keijer, J., Hopman, M. T. E., & Timmers, S. (2019) · Physiological Reviews · doi:10.1152/physrev.00002.2019 · Cited by 67 · see citing works
Perera, R., McFadden, E. C., McLellan, J., Lung, T. W.-C., Clarke, P., Pérez, T., Fanshawe, T. R., Dalton, A., Farmer, A. A., Glasziou, P., et al. (2015) · Health Technology Assessment · doi:10.3310/hta191000 · Cited by 63 · see citing works
Statins and Voriconazole Induce Programmed Cell Death in Acanthamoeba castellanii
Martín-Navarro, C. M., López‐Arencibia, A., Sifaoui, I., Reyes-Batllé, M., Valladares, B., Martínez‐Carretero, E., Piñero, J. E., Maciver, S. K., & Lorenzo‐Morales, J. (2015) · Antimicrobial Agents and Chemotherapy · doi:10.1128/aac.00066-15 · Cited by 60 · see citing works
Unhelpful information about adverse drug reactions
Tan, K., Petrie, K. J., Faasse, K., Bolland, M. J., & Grey, A. B. (2014) · BMJ · doi:10.1136/bmj.g5019 · Cited by 60 · see citing works
Cardiovascular risk assessment and lipid modification: NICE guideline
Duerden, M. G., O’Flynn, N., & Qureshi, N. (2015) · British Journal of General Practice · doi:10.3399/bjgp15x685933 · Cited by 59 · see citing works
Bruckert, É., Parhofer, K. G., González‐Juanatey, J. R., Nordestgaard, B. G., Arca, M., Giovas, P. P., & Ray, K. K. (2020) · Advances in Therapy · doi:10.1007/s12325-020-01285-2 · Cited by 59 · see citing works
Tonk, E. C. M., Gurwitz, D., der Zee, A. H. M., & Janssens, A. C. J. W. (2016) · The Pharmacogenomics Journal · doi:10.1038/tpj.2016.34 · Cited by 58 · see citing works
Discussion around statin discontinuation in older adults and patients with wasting diseases
Banach, M., & Serban, M. (2016) · Journal of Cachexia Sarcopenia and Muscle · doi:10.1002/jcsm.12109 · Cited by 56 · see citing works
Contemporary Management of Dyslipidemia
Ferraro, R., Leucker, T. M., Martin, S. S., Banach, M., Jones, S. R., & Toth, P. P. (2022) · Drugs · doi:10.1007/s40265-022-01691-6 · Cited by 56 · see citing works
A systematic review of factors associated with side‐effect expectations from medical interventions
Smith, L., Webster, R., & Rubin, G. J. (2020) · Health Expectations · doi:10.1111/hex.13059 · Cited by 54 · see citing works
Cost-Effectiveness of Lipid-Lowering Treatments in Young Adults
Kohli-Lynch, C. N., Bellows, B. K., Zhang, Y., Spring, B. J., Kazi, D. S., Pletcher, M. J., Vittinghoff, E., Allen, N. B., & Moran, A. E. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.08.065 · Cited by 52 · see citing works
Pharmacogenetic Foundations of Therapeutic Efficacy and Adverse Events of Statins
Arrigoni, E., Re, M. D., Fidilio, L., Fogli, S., Danesi, R., & Paolo, A. D. (2017) · International Journal of Molecular Sciences · doi:10.3390/ijms18010104 · Cited by 52 · see citing works
Establishment of an International Collaborative Network for N-of-1 Trials and Single-Case Designs
Nikles, J., Onghena, P., Vlaeyen, J. W. S., Wicksell, R. K., Simons, L. E., McGree, J. M., & McDonald, S. (2021) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2021.100826 · Cited by 48 · see citing works
Statins versus placebo for people with chronic obstructive pulmonary disease
Walsh, A., Perrem, L., Khashan, A. S., Henry, M. T., & Chróinín, M. N. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011959.pub2 · Cited by 48 · see citing works
Kohli-Lynch, C. N., Bellows, B. K., Thanassoulis, G., Zhang, Y., Pletcher, M. J., Vittinghoff, E., Pencina, M. J., Kazi, D. S., Sniderman, A. D., & Moran, A. E. (2019) · JAMA Cardiology · doi:10.1001/jamacardio.2019.2851 · Cited by 47 · see citing works
Hsieh, H.-C., Hsu, J. C., & Lu, C. Y. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-014150 · Cited by 44 · see citing works
Statin tolerability: In defence of placebo-controlled trials
Tobert, J. A., & Newman, C. B. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487315602861 · Cited by 43 · see citing works
Faasse, K., Grey, A. B., Horne, R., & Petrie, K. J. (2015) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.3751 · Cited by 41 · see citing works
Chin, Y. H., Lim, O. Z.-H., Lin, C., Chan, Y. Y., Kong, G., Ng, C. H., Chong, B., Syn, N. L. X., Chan, K. E., Muthiah, M. D., et al. (2022) · European Heart Journal - Quality of Care and Clinical Outcomes · doi:10.1093/ehjqcco/qcac060 · Cited by 40 · see citing works
Keen, H. I., Krishnarajah, J., Bates, T. R., & Watts, G. F. (2014) · Expert Opinion on Drug Safety · doi:10.1517/14740338.2014.937422 · Cited by 40 · see citing works
Galper, B. Z., Wang, Y. C., & Einstein, A. J. (2015) · PLoS ONE · doi:10.1371/journal.pone.0138092 · Cited by 38 · see citing works
Nocebo effects in health psychology
Faasse, K. (2019) · Australian Psychologist · doi:10.1111/ap.12392 · Cited by 38 · see citing works
Rhabdomyolysis-Induced AKI (RIAKI) Including the Role of COVID-19
Młynarska, E., Krzemińska, J., Wronka, M., Franczyk, B., & Rysz, J. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23158215 · Cited by 38 · see citing works
Turner, G., Calvert, M., Feltham, M. G., Ryan, R. P., Fitzmaurice, D., Cheng, K. K., & Marshall, T. P. (2016) · PLoS Medicine · doi:10.1371/journal.pmed.1002169 · Cited by 36 · see citing works
Brandts, J., Tittel, S. R., Bramlage, P., Danne, T., Brix, J. M., Zimny, S., Heyer, C. H. J., Holl, R. W., & Müller‐Wieland, D. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15264 · Cited by 30 · see citing works
Kaleağasıoğlu, F., Olcay, E., & Olgaç, V. (2015) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-015-3728-z · Cited by 30 · see citing works
Naci, H., van Valkenhoef, G., Higgins, J. P. T., Fleurence, R., & Ades, A. E. (2014) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.114.000825 · Cited by 28 · see citing works
Pfistermeister, B., Saß, A., Criegee‐Rieck, M., Bürkle, T., Fromm, M. F., & Maas, R. (2014) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2014.156 · Cited by 28 · see citing works
Kristiansen, O., Vethe, N. T., Peersen, K., Wang Fagerland, M., Sverre, E., Prunés Jensen, E., Lindberg, M., Gjertsen, E., Gullestad, L., Perk, J., et al. (2021) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvaa076 · Cited by 27 · see citing works
Kohli-Lynch, C. N., Lewsey, J., Boyd, K. A., French, D. D., Jordan, N., Moran, A. E., Sattar, N. A., Preiss, D., & Briggs, A. H. (2022) · Circulation · doi:10.1161/circulationaha.121.057631 · Cited by 25 · see citing works
The Power of Labeling in Nocebo Effects
Faasse, K., & Martin, L. R. (2018) · International review of neurobiology · doi:10.1016/bs.irn.2018.07.016 · Cited by 24 · see citing works
Nocebo response in Parkinson's disease: A systematic review and meta-analysis
Rato, M. L., Duarte, G. S., Nunes-Ferreira, A., Alves, M., Mainoli, B., Teodoro, T., Mestre, T., Costa, J. N., & Ferreira, J. J. (2019) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2019.04.015 · Cited by 24 · see citing works
Shah, 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 23 · see citing works
Leening, M. J. G., Cook, N. R., & Ridker, P. M. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw287 · Cited by 23 · see citing works
Cardiovascular risk and aging: the need for a more comprehensive understanding.
Majnarić, L. T., Bosnić, Z., Kurevija, T., & Wittlinger, T. (2021) · PubMed Central · doi:10.11909/j.issn.1671-5411.2021.06.004 · Cited by 22 · see citing works
Khalil, D., Boktor, M., Mortensen, E. M., Frei, C. R., & Mansi, I. A. (2015) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2015.02.035 · Cited by 22 · see citing works
Aarnio, E., Korhonen, M. J., Huupponen, R., & Martikainen, J. A. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.12.059 · Cited by 22 · see citing works
Yang, Q., Zhong, Y., Gillespie, C., Merritt, R. K., Bowman, B. A., George, M. G., & Flanders, W. D. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-011684 · Cited by 22 · see citing works
Keyes, E., Grinnell, M., Jacoby, D. S., Vazquez, T., Diaz, D., Werth, V. P., & Williams, K. J. (2021) · International Journal of Women’s Dermatology · doi:10.1016/j.ijwd.2021.08.015 · Cited by 21 · see citing works
Statin-associated muscle symptoms EAS Consensus Panel paper focuses on this neglected patient group
Stock, J. K. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.06.049 · Cited by 21 · see citing works
Mühlbauer, V., & Mühlhauser, I. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1160-1 · Cited by 20 · see citing works
Singh, H., authorship., T. A. H. C. E. T. T. W. A. S. F., Sikarwar, P., authorship., T. A. H. C. E. T. T. W. A. S. F., Khurana, S., & Sharma, J. (2022) · touchREVIEWS in Endocrinology · doi:10.17925/ee.2022.18.2.96 · Cited by 20 · see citing works
Statin intolerance – a question of definition
Algharably, E. A. E., Filler, I., Rosenfeld, S., Grabowski, K., & Kreutz, R. H. (2016) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2017.1238898 · Cited by 19 · see citing works
Distribution of lifespan gain from primary prevention intervention
Finegold, J. A., Shun-Shin, M. J., Cole, G. D., Zaman, S., Maznyczka, A., Zaman, S. U., Al-Lamee, R. K., Ye, S., & Francis, D. P. (2016) · Open Heart · doi:10.1136/openhrt-2015-000343 · Cited by 18 · see citing works
Self-citationA content analysis of the representation of statins in the British newsprint media
Chisnell, J., Marshall, T. P., Hyde, C., Zhelev, Z., & Fleming, L. E. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-012613 · Cited by 18 · see citing works
Son, K., & Bae, S. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-026603 · Cited by 18 · see citing works
Schweitzer, A. M., Gingrich, M. A., Hawke, T. J., & Rebalka, I. A. (2020) · European Journal of Applied Physiology · doi:10.1007/s00421-020-04360-2 · Cited by 18 · see citing works
Pharmacogenomics of statin therapy
Hopewell, J. C., Reith, C. A., & Armitage, J. (2014) · Current Opinion in Lipidology · doi:10.1097/mol.0000000000000125 · Cited by 17 · see citing works
Cost-Effectiveness of a Polypill for Cardiovascular Disease Prevention in an Underserved Population
Kohli-Lynch, C. N., Moran, A. E., Kazi, D. S., Bibbins-Domingo, K. B., Jordan, N., French, D. D., Zhang, Y., Wang, T. J., & Bellows, B. K. (2025) · JAMA Cardiology · doi:10.1001/jamacardio.2024.4812 · Cited by 16 · see citing works
Herrett, E. L., Williamson, E., Beaumont, D., Prowse, D., Youssouf, N. F., Brack, K. E., Armitage, J., Goldacre, B. M., MacDonald, T. M., van Staa, T. P., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016604 · Cited by 16 · see citing works
Self-citationDuarte, G. S., Rodrigues, F. B., Ferreira, J. J., & Costa, J. N. (2018) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2018.06.017 · Cited by 16 · see citing works
Statin Adverse Events in Primary Prevention: Between Randomized Trials and Observational Studies
Mansi, I. A., & Palmer, B. F. (2015) · The American Journal of the Medical Sciences · doi:10.1097/maj.0000000000000527 · Cited by 15 · see citing works
Statin Use and Self-Reported Hindering Muscle Complaints in Older Persons: A Population Based Study
van der Ploeg, M. A., Poortvliet, R. K. E., van Blijswijk, S. C. E., den Elzen, W. P. J., van Peet, P. G., de Ruijter, W., Blom, J. W., & Gussekloo, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0166857 · Cited by 15 · see citing works
Statins: Rationale, Mode of Action, and Side Effects
Sultan, S., D'Souza, A., Zabetakis, I., Lordan, R., Τσούπρας, Α., Kavanagh, E. P., & Hynes, N. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813792-5.00006-9 · Cited by 15 · see citing works
It is not just the drugs that matter: the nocebo effect
Wojtukiewicz, M. Z., Polityńska, B., Skalij, P., Tokajuk, P., Wojtukiewicz, A. M., & Honn, K. V. (2019) · Cancer and Metastasis Reviews · doi:10.1007/s10555-019-09800-w · Cited by 15 · see citing works
Sheth, S., Banach, M., & Toth, P. P. (2024) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2024.2398444 · Cited by 14 · see citing works
Schulman, K. L., Lamerato, L. E., Dalal, M. R., Sung, J., Jhaveri, M., Koren, A., Mallya, U. G., & Foody, J. M. (2016) · Value in Health · doi:10.1016/j.jval.2016.03.1858 · Cited by 14 · see citing works
Gizzo, S., Quaranta, M., Nardelli, G. B., & Noventa, M. (2015) · Current Drug Targets · doi:10.2174/1389450116666150330113239 · Cited by 14 · see citing works
Nilsson, G. H., Samuelsson, E. C., Söderström, L., & Mooe, T. (2016) · BMC Family Practice · doi:10.1186/s12875-016-0505-0 · Cited by 14 · see citing works
Hypolipidaemic and Insulin Secretagogue Activities of (R)-(−)-Carvone
Abbas, M. A., Oriquat, G. A., Abbas, M. M., Al-Najjar, B. O., & Kandil, Y. I. (2020) · Malaysian Journal of Medical Sciences · doi:10.21315/mjms2020.27.6.5 · Cited by 14 · see citing works
Liakopoulos, O. J., Kuhn, E. W., Hellmich, M., Kuhr, K., Krause, P., Reuter, H., Thurat, M., Choi, Y., & Wahlers, T. (2015) · American Heart Journal · doi:10.1016/j.ahj.2015.04.015 · Cited by 13 · see citing works
Development and Content Validity of the Statin Experience Assessment Questionnaire (SEAQ)©
Jacobson, T. A., Edelman, S. V., Galipeau, N., Shields, A. L., Mallya, U. G., Koren, A., & Davidson, M. H. (2016) · Patient · doi:10.1007/s40271-016-0211-y · Cited by 13 · see citing works
Statins and Lower Gastrointestinal Conditions: A Retrospective Cohort Study
Pearlman, M. Y., Covin, Y. N., Schmidt, R., Mortensen, E. M., & Mansi, I. A. (2017) · The Journal of Clinical Pharmacology · doi:10.1002/jcph.895 · Cited by 12 · see citing works
Bakker, E. A., Timmers, S., Hopman, M. T. E., Thompson, P. D., Verbeek, A. L. M., & Eijsvogels, T. M. H. (2017) · Sports Medicine · doi:10.1007/s40279-017-0681-7 · Cited by 12 · see citing works
Statin Use and Hyperglycemia: Do Statins Cause Diabetes?
Bredefeld, C., Choi, P., Cullen, T., Nicolich-Henkin, S., & Waters, L. (2024) · Current Atherosclerosis Reports · doi:10.1007/s11883-024-01266-8 · Cited by 11 · see citing works
Treat-to-target versus dose-adapted statin treatment of cholesterol to reduce cardiovascular risk
Müller‐Wieland, D., Assmann, G., Carmena, R., Davignon, J., von Eckardstein, A., Farinaro, E., Greten, H., OLSSON, A. G., Riesen, W. F., & Shlyakhto, E. V. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487314567001 · Cited by 11 · see citing works
Misinterpretation of trial evidence on statin adverse effects may harm patients
Golomb, B. A. (2014) · European Journal of Preventive Cardiology · doi:10.1177/2047487314533085 · Cited by 11 · see citing works
Genuine versus bogus scientific controversies: the case of statins
Martini, C. M. C., & Andreoletti, M. (2021) · History & Philosophy of the Life Sciences · doi:10.1007/s40656-021-00456-w · Cited by 11 · see citing works
Statin associated adverse reactions in Latin America: a scoping review
Urina-Jassir, M., Pacheco-Paez, T., Páez-Canro, C., & Urina‐Triana, M. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-050675 · Cited by 10 · see citing works
Finegold, J. A., & Francis, D. P. (2015) · European Journal of Preventive Cardiology · doi:10.1177/2047487314550805 · Cited by 9 · see citing works
Self-citationTudor, K., Brooks, J., Howick, J., Fox, R., & Aveyard, P. (2022) · Circulation: Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.120.007793 · Cited by 9 · see citing works
- Authors
- Finegold, J. A., Manisty, C. H., Goldacre, B., Barron, A. J., & Francis, D. P.
- Affiliations
- Imperial College London (GB)
- London School of Hygiene & Tropical Medicine (GB)
- National Heart and Lung Institute, Imperial College, London, UK
- Corresponding author
- Finegold, Judith A
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03-12
- Volume
- 21
- Issue
- 4
- Pages
- 464-474
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2105299596
- Cited by
- 214
- References
- 35
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 9 · 2023: 9 · 2022: 16 · 2021: 12 · 2020: 13 · 2019: 17 · 2018: 14 · 2017: 19 · 2016: 30 · 2015: 30 · 2014: 28
- FWCI
- 6.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Trust
- National Institute for Health and Care Research (FS/10/038)
- British Heart Foundation (FS 10/038, PG/11/36/2883, FS/10/38/28268)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- statins, adverse drug reactions, new-onset diabetes, liver transaminase elevation, muscle aches, cardiovascular disease prevention, primary prevention, secondary prevention, statin dose
- MeSH terms
- Diabetes Mellitus, Dose-Response Relationship, Drug, Humans, Liver, Muscular Diseases, Risk Factors, Biomarkers, Placebo Effect, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment, 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
