Side Effects of Statins May Be Tolerable

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Many people stop taking cholesterol-lowering statins due to muscle pain or nausea, but most people are able to resume taking a different type of the same drug.

Statins are among the most prescribed medications in the U.S., with one in four Americans over age 45 years relying on the drugs to lower cholesterol, according to the latest government statistics. But recent reports about their side effects, including serious muscle weakness, memory loss and an increased risk of diabetes, prompted many to discontinue the medications, at least temporarily.

In a study of more than 107,835 patients prescribed statins between 2000 and 2008, about 20% reported experiencing a side effect such as muscle pain or nausea related to the drugs, and about half of these patients stopped taking the statin. But more than 90% of these patients who started taking statins again, often turning to a different version of the drug, were able to tolerate the medications the second time around.

(MORE:FDA Warns Statin Users of Memory Loss and Diabetes Risks)

Published in the Annals of Internal Medicine, the findings encourage both patients andphysicians to consider restarting statin therapy, even if side effects lead them to stop for a brief period of time. A previous investigation of how discontinuing statin therapy could affect patients wasnt so optimistic; in 2006 researchers reported at the annual meeting of the American College of Cardiology that patients who stopped taking their statins saw an increase in their LDL cholesterol and inflammation levels, both of which increase the risk for heart disease.

That study, however, involved a relatively small number of patients 566 so Dr. Alex Turchin, of the Division of Endocrinology at Brigham and Womens Hospital and his colleagues set out to study the effect in a larger group of people. Theres the dichotomy of what we see in thefront-linesof routine clinical care and whats coming out of clinical trials, says Turchin, the studys senior author. In routine clinical care, we hear all the time from doctors or patients that they develop side effects to statins and that they have to stop statins. On the other hand, if you look at data from clinical trials, which compare statins to placebos, the incidence of side effects is almost the same between the statins and the placebo. So there was this discrepancy between the anecdotal experience and rigorously done studies. We wanted to do a more quantitative study to see what is actually going on.

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Turchin and his team reviewed medical records and doctors notes of the study participants from two different Boston hospitals. The majority who stopped using statins due to minor side effects were prescribed the drugs again within a year, andover90% were still taking the statins within the year after they reported quitting. Some were taking the same statin, and others were taking a different type or at a different dosage.

The results suggest that the side effects may be tolerable, or, by switching to another brand or dose of statin, even avoidable. The findings underscore the importance of balancing the benefits and risks of the medications; most studies show that the ability to control cholesterol and inflammation in heart patients outweighs the adverse effects of the drugs. Statins are one of the few classes of medications that we actually know save lives. There have been many studies that showed statins decrease all-cause mortality in both patients with a high-risk of heart disease and individuals who just have high cholesterol with no known heart disease, says Turchin. This has not been unequivocally shown for other cholesterol lowering medications; just for statins. Generally there are not many medications out there which we can reliably say they save lives.

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Side Effects of Statins May Be Tolerable