Statin Associated Muscle Adverse Effects: From Presentation to Management.

Statins inhibit β-Hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase, an enzyme involved in cholesterol synthesis, and are widely used for primary and secondary prevention of cardiovascular events. They are generally well tolerated but may cause muscle symptoms ranging from myalgias, myopathy, myositis to rhabdomyolysis. More recently, studies have reported autoimmune necrotizing myopathy associated with statin use, characterized by progressive symmetric weakness even after discontinuation of statins, often warranting immunosuppressive treatment. We describe the spectrum of statin associated muscle adverse effects for primary care physician including the clinical presentation, etiology, diagnostic workup, and appropriate management.