Step-by-step diagnosis and management of the nocebo/drucebo effect in statin-associated muscle symptoms patients: a position paper from the International Lipid Expert Panel (ILEP)
- Authors: Penson, Peter E; Bruckert, Eric; Marais, David; Reiner, Željko; Pirro, Matteo; Sahebkar, Amirhossein; Bajraktari, Gani; Mirrakhimov, Erkin; Rizzo, Manfredi; Mikhailidis, Dimitri P; Sachinidis, Alexandros; Gaita, Dan; Latkovskis, Gustavs; Mazidi, Mohsen; Toth, Peter P; Pella, Daniel; Alnouri, Fahad; Postadzhiyan, Arman; Yeh, Hung-I; Mancini, G B John; von Haehling, Stephan; Banach, Maciej
- Publication year: 2022
- Type: Review essay (rassegna critica)
- OA Link: http://hdl.handle.net/10447/584547
Abstract
Statin intolerance is a clinical syndrome whereby adverse effects (AEs) associated with statin therapy [most commonly statin-associated muscle symptoms (SAMS)] result in the discontinuation of therapy and consequently increase the risk of adverse cardiovascular outcomes. However, complete statin intolerance occurs in only a small minority of treated patients (estimated prevalence of only 3-5%). Many perceived AEs are misattributed (e.g. physical musculoskeletal injury and inflammatory myopathies), and subjective symptoms occur as a result of the fact that patients expect them to do so when taking medicines (the nocebo/drucebo effect)-what might be truth even for over 50% of all patients with muscle weakness/pain. Clear guidance is necessary to enable the optimal management of plasma in real-world clinical practice in patients who experience subjective AEs. In this Position Paper of the International Lipid Expert Panel (ILEP), we present a step-by-step patient-centred approach to the identification and management of SAMS with a particular focus on strategies to prevent and manage the nocebo/drucebo effect and to improve long-term compliance with lipid-lowering therapy.