BACKGROUND: Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins. METHODS: Major trials and review articles on the safety of statins were identified in a search of the MEDLINE database from 1980 to 2016, which was limited to English articles. RESULTS: Myalgia is the most common side effect of statin use, with documented rates from 1-10%. Rhabdomyolysis is the most serious adverse effect from statin use, though it occurs quite rarely (less than 0.1%). The most common risk factors for statin-related myopathy include hypothyroidism, polypharmacy and alcohol abuse. Derangement in liver function tests is common, affecting up to 1% of patients; however, the clinical significance of this is unknown. Some statin drugs are potentially diabetogenic and the risk appears to increase in those patients on higher doses. Pitavastatin has not been associated with increased risk of diabetes. Statins have not been proven to increase the risk of malignancy, dementia, mood disorders or acute interstitial nephritis. However, statins do have multiple drug interactions, primarily those which interact with the cytochrome p450 enzyme group. CONCLUSIONS: Overall, statin drugs appear to be safe for use in the vast majority of patients. However, patients with multiple medical co-morbidities are at increased risk of adverse effects from long-term statin use.
BACKGROUND: Hydroxymethyl glutaryl coenzyme A reductase inhibitors, commonly called statins, are some of the most commonly prescribed medications worldwide. Evidence suggests that statin therapy has significant mortality and morbidity benefit for both primary and secondary prevention from cardiovascular disease. Nonetheless, concern has been expressed regarding the adverse effects of long term statin use. The purpose of this article was to review the current medical literature regarding the safety of statins. METHODS: Major trials and review articles on the safety of statins were identified in a search of the MEDLINE database from 1980 to 2016, which was limited to English articles. RESULTS:Myalgia is the most common side effect of statin use, with documented rates from 1-10%. Rhabdomyolysis is the most serious adverse effect from statin use, though it occurs quite rarely (less than 0.1%). The most common risk factors for statin-related myopathy include hypothyroidism, polypharmacy and alcohol abuse. Derangement in liver function tests is common, affecting up to 1% of patients; however, the clinical significance of this is unknown. Some statin drugs are potentially diabetogenic and the risk appears to increase in those patients on higher doses. Pitavastatin has not been associated with increased risk of diabetes. Statins have not been proven to increase the risk of malignancy, dementia, mood disorders or acute interstitial nephritis. However, statins do have multiple drug interactions, primarily those which interact with the cytochrome p450 enzyme group. CONCLUSIONS: Overall, statin drugs appear to be safe for use in the vast majority of patients. However, patients with multiple medical co-morbidities are at increased risk of adverse effects from long-term statin use.
Authors: Jarir Atthobari; Auke H Brantsma; Ron T Gansevoort; Sipke T Visser; Folkert W Asselbergs; Wiek H van Gilst; Paul E de Jong; Lolkje T W de Jong-van den Berg Journal: Nephrol Dial Transplant Date: 2006-05-23 Impact factor: 5.992
Authors: Dick de Zeeuw; Deborah A Anzalone; Valerie A Cain; Michael D Cressman; Hiddo J Lambers Heerspink; Bruce A Molitoris; John T Monyak; Hans-Henrik Parving; Giuseppe Remuzzi; James R Sowers; Donald G Vidt Journal: Lancet Diabetes Endocrinol Date: 2015-02-04 Impact factor: 32.069
Authors: Michelle C Odden; Mark J Pletcher; Pamela G Coxson; Divya Thekkethala; David Guzman; David Heller; Lee Goldman; Kirsten Bibbins-Domingo Journal: Ann Intern Med Date: 2015-04-21 Impact factor: 25.391
Authors: Sripal Bangalore; Rana Fayyad; G Kees Hovingh; Rachel Laskey; Liffert Vogt; David A DeMicco; David D Waters Journal: Am J Cardiol Date: 2014-04-03 Impact factor: 2.778
Authors: Zeljko Reiner; Alberico L Catapano; Guy De Backer; Ian Graham; Marja-Riitta Taskinen; Olov Wiklund; Stefan Agewall; Eduardo Alegria; M John Chapman; Paul Durrington; Serap Erdine; Julian Halcox; Richard Hobbs; John Kjekshus; Pasquale Perrone Filardi; Gabriele Riccardi; Robert F Storey; David Wood Journal: Eur Heart J Date: 2011-06-28 Impact factor: 29.983
Authors: M Regina Castro; Gyorgy Simon; Stephen S Cha; Barbara P Yawn; L Joseph Melton; Pedro J Caraballo Journal: J Gen Intern Med Date: 2016-02-05 Impact factor: 5.128
Authors: David Preiss; Sreenivasa Rao Kondapally Seshasai; Paul Welsh; Sabina A Murphy; Jennifer E Ho; David D Waters; David A DeMicco; Philip Barter; Christopher P Cannon; Marc S Sabatine; Eugene Braunwald; John J P Kastelein; James A de Lemos; Michael A Blazing; Terje R Pedersen; Matti J Tikkanen; Naveed Sattar; Kausik K Ray Journal: JAMA Date: 2011-06-22 Impact factor: 56.272
Authors: Mark W Russo; Jay H Hoofnagle; Jiezhun Gu; Robert J Fontana; Huiman Barnhart; David E Kleiner; Naga Chalasani; Herbert L Bonkovsky Journal: Hepatology Date: 2014-05-13 Impact factor: 17.425
Authors: Ange Wang; Aaron K Aragaki; Jean Y Tang; Allison W Kurian; JoAnn E Manson; Rowan T Chlebowski; Michael Simon; Pinkal Desai; Sylvia Wassertheil-Smoller; Simin Liu; Stephen Kritchevsky; Heather A Wakelee; Marcia L Stefanick Journal: Br J Cancer Date: 2016-06-09 Impact factor: 7.640
Authors: Katharine Fernandez; Katie K Spielbauer; Aaron Rusheen; Lizhen Wang; Tiffany G Baker; Stephen Eyles; Lisa L Cunningham Journal: Hear Res Date: 2020-02-06 Impact factor: 3.208
Authors: Kamlesh Khunti; Mark D Danese; Lucie Kutikova; David Catterick; Francisco Sorio-Vilela; Michelle Gleeson; Sreenivasa Rao Kondapally Seshasai; Jack Brownrigg; Kausik K Ray Journal: JAMA Netw Open Date: 2018-12-07