Statins not linked to muscle pain

Article written by Bruce Sylvester

British researchers report finding no link between statin therapy and muscle pain. The findings appeared on Feb.28, 2021 in the BMJ/British Medical Journal.

“No overall effect of atorvastatin 20 mg on muscle symptoms compared with placebo was found in participants who had previously reported severe muscle symptoms when taking statins,” the authors said.

As background, the authors noted that statin therapy, which is used to prevent heart disease and stroke, has acquired the unproven reputation of causing muscle pain and stiffness.

They enrolled 200 subjects (average age 69.5 years) from 50 general practices in England and Wales. All had recently stopped or were considering stopping statin treatment due to muscle pain.

Each subject was part of an individual randomized, placebo-controlled trial (known as an n-of-1 trial). The researchers combined the individual results to evaluate the overall side effects of statin treatment.

The subjects were randomized to a sequence of six, two-month treatment periods in which they received either statin therapy (atorvastatin 20mg daily) or placebo.

In their primary analysis, the investigators compared symptom scores in the statin and placebo periods; 151 subjects provided symptoms scores for at least one statin period and one placebo period and were, therefore, included in the primary analysis.

The researchers found no overall difference in muscle pain scores between the statin and placebo periods (P=0.40).

Due to severe muscle symptoms, 18 subjects (9%) withdrew during a statin period and 13 (7%) withdrew during a placebo period.

The authors concluded, “We found no differences in the frequency or severity of muscle symptoms between the statin and control periods. Also, we found no differences for the effect of muscle symptoms on aspects of daily life (general activity, mood, ability to walk, normal work, relationships with other people, sleep, and enjoyment of life) between the statin and control periods. Missing outcome data were equally distributed between the statin and placebo periods, making it unlikely that muscle symptoms contributed to missed outcome data collection. Of those completing the trial, most (88%) said that their n-of-1 trial had been helpful, with nearly two thirds reporting that they intended to restart treatment with statins.”