New research published Thursday in The Lancet Digital Health found that serious statin-related muscle disorders are extremely rare, based on medical record data from nearly 6 million adults in the United Kingdom. Only about 0.04% had a 10-year risk above 10%.
For people who could benefit from statins, that finding narrows a fear that has kept many from treatment. Doctors involved in the research said the numbers should help patients and clinicians weigh risk against the LDL-lowering effects of these drugs.
Dr. Steve Nissen on Statin risk
Dr. Steve Nissen, chief academic officer of the Heart, Vascular & Thoracic Institute at Cleveland Clinic, said: "In the 40 years I have been practicing I have never admitted a patient to the hospital from a muscle disorder associated with statins". His experience matches the study’s central result: serious muscular problems were rare across myopathy, myalgia and rhabdomyolysis.
The study’s estimate can also be read another way. If 0.04% of nearly 6 million adults had a 10-year risk above 10%, that means the high-risk group was about 2,400 people in a population that size. By comparison, an American Heart Association report put myopathy at less than 1% and rhabdomyolysis at less than 0.1%.
Duke Health and Oregon Health and Science University
Dr. Nishant Shah, a preventive cardiologist at Duke Health, said: "There is a huge worry in the general population about these drugs based on rare side effects". Dr. Bart Duell, a professor of medicine at Oregon Health and Science University, said: "Even if you increase that tenfold, that is still a very tiny risk" and that it is "really isn’t a reason to not use statins".
The study adds pressure to a familiar gap between evidence and use. Statins can lower LDL cholesterol by as much as 60%, yet less than half of the 50 million people in the United States who could benefit from them use them, up to one-third never fill their prescriptions, and about 40% quit within three months.
Ting Cai and statin hesitancy
Ting Cai, a study co-author, said: "It’s unclear to us why statin side effects draw so much attention compared to other drugs". In clinical trials, people taking a statin were slightly more likely to report mild muscle pain than people taking a placebo, but in the majority of those cases the pain had been caused by something other than the drug.
That leaves the practical takeaway for patients and doctors: the serious muscle disorders that often worry people are uncommon enough that they should not drive treatment decisions on their own. The harder part now is not whether the risk exists, but how the new risk-prediction tool will sort out which patients actually face it.
