Step-by-step diagnosis and management of the nocebo/drucebo effect in statin-associated muscle symptoms patients: a position paper from the International Lipid Expert Panel (ILEP)

International Lipid Expert Panel (ILEP)

Research output: Contribution to journalReview articlepeer-review

10 Scopus citations

Abstract

Statin intolerance is a clinical syndrome whereby adverse effects (AEs) associated with statin therapy [most commonly statin-associated muscle symptoms (SAMS)] result in the discontinuation of therapy and consequently increase the risk of adverse cardiovascular outcomes. However, complete statin intolerance occurs in only a small minority of treated patients (estimated prevalence of only 3–5%). Many perceived AEs are misattributed (e.g. physical musculoskeletal injury and inflammatory myopathies), and subjective symptoms occur as a result of the fact that patients expect them to do so when taking medicines (the nocebo/drucebo effect)—what might be truth even for over 50% of all patients with muscle weakness/pain. Clear guidance is necessary to enable the optimal management of plasma in real-world clinical practice in patients who experience subjective AEs. In this Position Paper of the International Lipid Expert Panel (ILEP), we present a step-by-step patient-centred approach to the identification and management of SAMS with a particular focus on strategies to prevent and manage the nocebo/drucebo effect and to improve long-term compliance with lipid-lowering therapy.

Original languageEnglish (US)
Pages (from-to)1596-1622
Number of pages27
JournalJournal of Cachexia, Sarcopenia and Muscle
Volume13
Issue number3
DOIs
StatePublished - Jun 2022

Keywords

  • Drucebo effect
  • Nocebo effect
  • SAMS
  • Statin intolerance

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physiology (medical)

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