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    Home > Medical News > Medical World News > NEJM: "Wrong" statins, common myalgia problems are not pharmacological side effects?

    NEJM: "Wrong" statins, common myalgia problems are not pharmacological side effects?

    • Last Update: 2021-01-20
    • Source: Internet
    • Author: User
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    Statins are the most widely used cholesterol-lowering drug, and the role of preventing deaths from heart attacks, strokes and even cardiovascular diseases is supported by a wealth of evidence.
    most patients are resistant to statins, but myalgia and fatigue have long been considered common side effects of statins.
    estimated that about one-half of patients may be suspended due to these adverse reactions.
    now, statins are expected to "take off" the "hat" of these side effects.
    patients taking statins and placebos experienced similar adverse reactions, according to a clinical trial recently published at the American Heart Association's (AHA) 2020 scientific meeting.
    that this is mainly caused by the "nocebo effect" rather than the actual pharmacological effects of the drug.
    antisebody effect is that patients experience side effects as a result of negative associations with the treatment.
    results were published simultaneously in the New England Journal of Medicine, a leading medical journal.
    screenshot Source: New England Journal of Medicine Has a long history of discussion about adverse reactions to statins.
    in large observational studies, statins had a 20 to 50 percent higher rate of myalgia than non-patients.
    in randomized controlled trials, people who took statins had almost the same adverse reaction rates as the placebo group.
    more typical example is the ASCOT trial, which compared attovastatin and placebo in nearly 10,000 patients.
    in the trial blind phase, there was no significant difference in myalgia symptoms between the two groups, and more patients in the statin group reported muscle symptoms during the open label phase.
    why do observational studies and randomized controlled trials produce very different results? One explanation is that clinical trials have a transition period that screens out patients with adverse reactions;
    to find out, researchers at Imperial College London led the small double-blind clinical trial.
    60 patients who had previously been suspended for side effects during the two weeks of statin treatment were included between June 2016 and March 2019.
    trials were designed with an "N-to-1" design, meaning that each patient was treated as his or her own control.
    patients received a total of 12 bottles of the drug, four containing atovastatin, four containing a placebo and four empty bottles.
    for a year, patients were treated in random order with a one-month course of treatment per bottle.
    , patients are required to report the extent of symptoms of related adverse reactions (0-100 points) per day.
    if the symptoms are so severe that the patient cannot stand them, the drug can be stopped during the month.
    this design helps to reflect the actual situation of clinical drug use.
    a total of 49 people completed all the trials.
    24 of them stopped at least one month of trials because of intolerable side effects, a total of 71 stops.
    31 of the 71 drug suspensions occurred during the placebo month and 40 during the statin month.
    in all 60 patients, the average symptom strength was 8, 15.4 and 16.3 points, respectively, in months without medication (empty bottles), placebo and statins.
    between placebo and statin months was similar, but significantly different from empty bottle months.
    12-month trial (left) and the remaining 11 (right) patients reported symptom strength.
    circle represents an average score of one month, regardless of whether the medication was discontinued in the current month.
    red circle for statins, blue circles for placebos, gray circles for empty bottles without medication months.
    (Photo Source: Supplied) further statistics on adverse reactions found that 90 per cent of these patients developed symptoms when taking statins, as well as placebo tablets.
    our study shows that the side effects of statins are not caused by the drug itself, but by (the patient's) use of the drug (psychological effect).
    side effects may also be due to typical pain in the elderly population itself.
    , a clinical researcher at Imperial College and a cardiologist, explained, "This finding is significant and provides further evidence that statins have mild side effects and that these drugs play an important role in maintaining patients' cardiovascular health."
    , of course, the team acknowledges that further analysis is needed to determine whether the remaining 10 percent of the remaining symptoms are pharmacological when patients take statins.
    at the AHA's annual meeting, Dr. Francine K. Welty of beth Israel Deacons Medical Center, who was invited to discuss the study, made a more cautious reading.
    She noted that the patients included in the study were those who had previously reported adverse reactions within 2 weeks of receiving statins, however, this antisagebody effect may not be extended to all patients considering that "drug-related side effects are usually most pronounced in the first few weeks of treatment and gradually diminish over time."
    , on the other hand, combined with the data from the observational studies and clinical trials mentioned above, the antisolbod effect is vinable.
    Overall, based on these findings, the team recommends that doctors communicate with patients about the drug's "antispolytic effects" when prescribing statins, help patients establish reasonable expectations for the drug, and encourage patients to continue taking statins to avoid the cardiovascular risk of stopping the drug.
    addition, doctors still need to be equal to patients, and although the source of symptoms may not be pharmacological, patients who report side effects do experience these symptoms.
    fact, six months after the end of the trial, more than half of the patients (34 people) had re-or planned to receive statins again.
    References to Frances A. Wood, et al., (2020). N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects. N Engl J Med, DOI: 10.1056/NEJMc2031173[2] Patients taking statins experience similar side effects from dummy pills. Retrieved November 16, 2020, from SAMSON Answers the Statin Side Effect Question. Retrieved November 16, 2020, from SAMSON Pins Most Muscle Pain Experienced With Statins on the Nocebo Effect. Retrieved November 16, 2020, from
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