Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel: This paper is also published in parallel in Archives of Medical Science [Banach M, Rizzo M, Toth PP, et al. Statin intolerance – an attempt at a unified definition. Position paper from an International Lipid Expert Panel. Arch Med Sci 2015; 11(1): 1–23]
Open accessAbstract
Statins are one of the most commonly prescribed drugs in clinical practice. They are usually well tolerated and effectively prevent cardiovascular events. Most adverse effects associated with statin therapy are muscle-related. The recent statement of the European Atherosclerosis Society (EAS) has focused on statin-associated muscle symptoms (SAMS), and avoided the use of the term 'statin intolerance'. Although muscle syndromes are the most common adverse effects observed after statin therapy, excluding other side effects might underestimate the number of patients with statin intolerance, which might be observed in 10 - 15% of patients. In clinical practice, statin intolerance limits effective treatment of patients at risk of, or with, cardiovascular disease. Knowledge of the most common adverse effects of statin therapy that might cause statin intolerance and the clear definition of this phenomenon is crucial to effectively treat patients with lipid disorders. Therefore, the aim of this position paper was to suggest a unified definition of statin intolerance, and to complement the recent EAS statement on SAMS, where the pathophysiology, diagnosis and the management were comprehensively presented.
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Association of Statin Use With Cataracts
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Self-citationEffect of Statins on Creatine Kinase Levels Before and After a Marathon Run
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Statins and Interstitial Lung Disease
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Lipids, blood pressure and kidney update 2014
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Self-citationStatins and primary liver cancer
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Lipid, blood pressure and kidney update 2013
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Self-citationStatin use and risk of hepatocellular carcinoma
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Statin Therapy and New-onset Diabetes: Molecular Mechanisms and Clinical Relevance
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Self-citationTime for new indications for statins?
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High-dose Atorvastatin After Stroke or Transient Ischemic Attack
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State of the art papers Lipids, blood pressure, kidney – what was new in 2011?
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Rhabdomyolysis and Satin Therapy: Relevance to the Elderly
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Use of statins is associated with an increased risk of rheumatoid arthritis
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Proprotein Convertase Subtilisin/Kexin 9 Inhibitors
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Self-citationHow to use statins in patients with chronic liver disease.
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Toxic Epidermal Necrolysis From Atorvastatin
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Yes! Statins can be given to liver patients
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Self-citationAdolescent with Rhabdomyolysis due to Undiagnosed Hypothyroidism
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Editorial Statin treatment in the elderly: how much do we know?
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Self-citationThe Role of Nutraceuticals in Statin Intolerant Patients
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Self-citationManagement of Statin Intolerance in 2018: Still More Questions Than Answers
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Self-citationPoLA/CFPiP/PCS/PSLD/PSD/PSH guidelines on diagnosis and therapy of lipid disorders in Poland 2021
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Self-citationPenson, 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
Self-citationStatins, Muscle Disease and Mitochondria
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Self-citationPoLA/CFPiP/PCS guidelines for the management of dyslipidaemias for family physicians 2016
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Self-citationMuscle Toxicity of Drugs: When Drugs Turn Physiology into Pathophysiology
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Self-citationLipids, blood pressure and kidney update 2015
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Self-citationEvaluating bempedoic acid for the treatment of hyperlipidaemia
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Self-citationCurrent Cardiovascular Risk Reports
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Self-citationThe effect of bergamot on dyslipidemia
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Statins and LDL-C in Secondary Prevention—So Much Progress, So Far to Go
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Self-citationMuscle and statins: from toxicity to the nocebo effect
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Self-citationAn evaluation of RVX-208 for the treatment of atherosclerosis
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Self-citationMulti-Centre Study on Cardiovascular Risk Management on Patients Undergoing AAA Surveillance
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The Effects of Melatonin on Elevated Liver Enzymes during Statin Treatment
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Self-citationRecent Advances in Developing PCSK9 Inhibitors for lipid-lowering Therapy
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Self-citationNew insights into the role of bempedoic acid and ezetimibe in the treatment of hypercholesterolemia
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SAMSON and the Nocebo Effect: Management of Statin Intolerance
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Self-citationStatin intolerance – a question of definition
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Self-citationPharmacokinetic drug evaluation of ezetimibe + simvastatin for the treatment of hypercholesterolemia
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Self-citationStatin‐associated muscle symptoms—A review: Individualizing the approach to optimize care
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LDL-Cholesterol-Lowering Therapy
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Countering clinical inertia in lipid management: Expert workshop summary
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Clinical utility of evolocumab in the management of hyperlipidemia: patient selection and follow-up
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Dyslipidaemia in the elderly: to treat or not to treat?
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Bempedoic acid: new evidence and recommendations on use
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Self-citationCombination Therapy In Dyslipidemia
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Thrombosis in vasculitis: An updated review of etiology, pathophysiology, and treatment
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Self-citationLipid-lowering Therapies in Myositis
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Evinacumab for the treatment of homozygous familial hypercholesterolemia
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Maghsoodi, N., & Wierzbicki, A. S. (2016) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000000282 · Cited by 10 · see citing works
Shah, P. K., Glueck, C. J., Goldenberg, N., Min, S., Mahida, C., Schlam, I. M., Rothschild, M., Huda, A. N., & Wang, P. (2017) · Lipids in Health and Disease · doi:10.1186/s12944-017-0416-7 · Cited by 9 · see citing works
Parhofer, K. G., Anastassopoulou, A., Calver, H., Becker, C., Rathore, A., Dave, R., & Zamfir, C. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12020705 · Cited by 9 · see citing works
Asgari, S., Abdi, H., Hezaveh, A. M., Moghisi, A., Etemad, K., Beni, H. R., & Khalili, D. (2018) · Scientific Reports · doi:10.1038/s41598-018-23364-9 · Cited by 9 · see citing works
Morales, C., Plana, N., Arnau, A., Matas, L., Mauri, M., Vila, À., Vila, L., Soler, C., Montesinos, J., Masana, L., et al. (2018) · Clínica e Investigación en Arteriosclerosis (English Edition) · doi:10.1016/j.artere.2017.07.005 · Cited by 9 · see citing works
Cárdenas, J. D. G., Oliveira, V. H. F., Borsari, A. L., Marinello, P. C., Longenecker, C. T., & Deminice, R. (2023) · Scientific Reports · doi:10.1038/s41598-023-31643-3 · Cited by 8 · see citing works
Cholesterol Management in the Era of PCSK9 Inhibitors
Svatikova, A., & Kopecky, S. L. (2017) · Current Cardiology Reports · doi:10.1007/s11886-017-0891-5 · Cited by 8 · see citing works
Krentz, A. J., Haddon-Hill, G., Zou, X., Pankova, N., & Jaun, A. Y. R. (2023) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2023.0009 · Cited by 8 · see citing works
Statin-associated side effects in patients attending a lipid clinic: evidence from a 6-year study
Barkas, F., Adamidis, P. S., Koutsogianni, A.-D., Liamis, G. L., & Liberopoulos, E. N. (2021) · Archives of Medical Science - Atherosclerotic Diseases · doi:10.5114/amsad.2021.111313 · Cited by 7 · see citing works
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- Authors
- 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., Greenfield, R. S., Hovingh, G. K., Kostner, K., Serban, C., Lighezan, D., Fras, Z., Moriarty, P. M., Muntner, P., Goudev, A., Ceska, R., Nicholls, S. J., Broncel, M., Nikolic, D., Pella, D., Puri, R., Rysz, J., Wong, N. D., Bajnok, L., Jones, S. R., Ray, K. K., & Mikhailidis, D. P.
- Affiliations
- Medical University of Lodz (PL)
- University of Palermo (IT)
- University of Chicago (US)
- Westchester Medical Center (US)
- University of Belgrade (RS)
- Amsterdam UMC Location University of Amsterdam (NL)
- The University of Queensland (AU)
- Victor Babeș University of Medicine and Pharmacy Timișoara (RO)
- University of Ljubljana (SI)
- University of Kansas Medical Center (US)
- University of Alabama (US)
- Queen Giovanna Hospital (BG)
- South Australian Health and Medical Research Institute (AU)
- University of Pavol Jozef Šafárik (SK)
- Indraprastha Apollo Hospitals (IN)
- University of California, Irvine (US)
- Johns Hopkins Medicine (US)
- Imperial College London (GB)
- The Royal Free Hospital (GB)
- ORCID
- Banach, Maciej
- Rizzo, Manfredi
- Toth, Peter P
- Farnier, Michel
- Davidson, Michael H
- Aronow, Wilbert S
- Djuric, Dragan M
- Hovingh, G Kees
- Lighezan, Daniel
- Fras, Zlatko
- Moriarty, Patrick M
- Muntner, Paul
- Goudev, Assen
- Nicholls, Stephen J
- Broncel, Marlena
- Pella, Daniel
- Puri, Raman
- Rysz, Jacek
- Wong, Nathan D
- Jones, Steven R
- Ray, Kausik K
- Mikhailidis, Dimitri P
- Venue
- Expert Opinion on Drug Safety
- Publisher
- Informa UK Limited
- Published
- 2015-04-24
- Volume
- 14
- Issue
- 6
- Pages
- 935-955
- ISSN
- 1474-0338 (ISSN-L)
- 1744-764X
- OpenAlex
- W2105307761
- Cited by
- 162
- References
- 205
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 6 · 2023: 13 · 2022: 13 · 2021: 10 · 2020: 14 · 2019: 12 · 2018: 21 · 2017: 25 · 2016: 24 · 2015: 10 · 2013: 1
- FWCI
- 26.88
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- other-oa
- Locations
- Expert Opinion on Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- statin intolerance, statin-associated muscle symptoms, statin adverse effects, lipid metabolism disorders, cardiovascular disease prevention, statin therapy
- MeSH terms
- Cardiovascular Diseases, Humans, Muscular Diseases, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Dyslipidemias
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.
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