PMID- 32729743 OWN - NLM STAT- MEDLINE DCOM- 20210204 LR - 20220417 IS - 1744-7607 (Electronic) IS - 1742-5255 (Linking) VI - 16 IP - 9 DP - 2020 Sep TI - Statin intolerance: an updated, narrative review mainly focusing on muscle adverse effects. PG - 837-851 LID - 10.1080/17425255.2020.1802426 [doi] AB - INTRODUCTION: Statins have been established as the standard of care for dyslipidemia and preventing cardiovascular diseases while posing few safety concerns. However, misconceptions about statin intolerance lead to their underuse, indicating a need to improve the understanding of the safety of this treatment. AREAS COVERED: We searched PubMed and reviewed literatures related to statin intolerance published between February 2015 and February 2020. Important large-scale or landmark studies published before 2015 were also cited as key evidence. EXPERT OPINION: Optimal lowering of low-density lipoprotein cholesterol with statins substantially reduces the risk of cardiovascular events. Muscle adverse events (AEs) were the most frequently reported AEs by statin users in clinical practice, but they usually occurred at a similar rate with statins and placebo in randomized controlled trials and had a spurious causal relationship with statin treatment. We proposed a rigorous definition for identifying true statin intolerance and present the criteria for defining different forms of muscle AEs and an algorithm for their management. True statin intolerance is uncommon, and every effort should be made to exclude false statin intolerance and ensure optimal use of statins. For the management of statin intolerance, statin-based approaches should be prioritized over non-statin approaches. FAU - Li, Jian-Jun AU - Li JJ AD - State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China. FAU - Liu, Hui-Hui AU - Liu HH AD - State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China. FAU - Wu, Na-Qiong AU - Wu NQ AD - State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College , 100037, Beijing, China. FAU - Yeo, Khung Keong AU - Yeo KK AD - Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore. FAU - Tan, Kathryn AU - Tan K AD - Department of Medicine, University of Hong Kong , Hong Kong, China. FAU - Ako, Junya AU - Ako J AD - Department of Cardiovascular Medicine, Kitasato University , Sagamihara, Japan. FAU - Krittayaphong, Rungroj AU - Krittayaphong R AD - Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University , Bangkok, Thailand. FAU - Tan, Ru San AU - Tan RS AD - Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore. FAU - Aylward, Philip E AU - Aylward PE AD - South Australian Health and Medical Research Institute and Flinders University , Adelaide, Australia. FAU - Baek, Sang Hong AU - Baek SH AD - Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea , Seoul, Korea. FAU - Dalal, Jamshed AU - Dalal J AD - Centre for Cardiac Sciences, Kokilaben Dhirubhai Ambani Hospital , Mumbai, India. FAU - Fong, Alan Yean Yip AU - Fong AYY AD - Department of Cardiology, Sarawak Heart Centre; and Clinical Research Centre, Sarawak General Hospital , Kuching, Malaysia. FAU - Li, Yi-Heng AU - Li YH AD - Division of Cardiology, Department of Internal Medicine, National Cheng Kung University College of Medicine and Hospital , Tainan, Taiwan. FAU - O'Brien, Richard C AU - O'Brien RC AD - Department of Endocrinology, Austin Health, University of Melbourne , Melbourne, Australia. FAU - Lim, Tien Siang Eric AU - Lim TSE AD - Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore. FAU - Koh, Si Ya Natalie AU - Koh SYN AD - Department of Cardiology, National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences , Singapore. FAU - Scherer, Daniel J AU - Scherer DJ AD - South Australian Health and Medical Research Institute, University of Adelaide , Adelaide, South Australia, Australia. FAU - Tada, Hayato AU - Tada H AD - Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine , Kanazawa, Japan. FAU - Kang, Vernon AU - Kang V AD - Singapore Heart Foundation , Singapore. FAU - Butters, Julie AU - Butters J AD - Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University , Melbourne, Australia. FAU - Nicholls, Stephen J AU - Nicholls SJ AD - Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University , Melbourne, Australia. LA - eng PT - Journal Article PT - Review DEP - 20200811 PL - England TA - Expert Opin Drug Metab Toxicol JT - Expert opinion on drug metabolism & toxicology JID - 101228422 RN - 0 (Cholesterol, LDL) RN - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors) SB - IM MH - Algorithms MH - Cardiovascular Diseases/etiology/prevention & control MH - Cholesterol, LDL/blood MH - Dyslipidemias/complications/*drug therapy MH - Humans MH - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage/adverse effects MH - Muscular Diseases/*chemically induced/diagnosis OTO - NOTNLM OT - Cardiovascular disease OT - Statin OT - definition OT - dyslipidemia OT - management OT - mechanism OT - muscle toxicity OT - nonstatin OT - statin intolerance EDAT- 2020/07/31 06:00 MHDA- 2021/02/05 06:00 CRDT- 2020/07/31 06:00 PHST- 2020/07/31 06:00 [pubmed] PHST- 2021/02/05 06:00 [medline] PHST- 2020/07/31 06:00 [entrez] AID - 10.1080/17425255.2020.1802426 [doi] PST - ppublish SO - Expert Opin Drug Metab Toxicol. 2020 Sep;16(9):837-851. doi: 10.1080/17425255.2020.1802426. Epub 2020 Aug 11.