A SAMSON nyomán: statinintolerancia, nocebohatás, adherencia

Abstract

Series of clinical studies proved the beneficial effect of lipid lowering therapy on the process of atherosclerosis and the frequency of the cardiovascular events, and according to these it plays an awarded role in the preventive treatment recommendations. In the most recent European dyslipidemia guidelines a lower LDL-cholesterol target has been established. Despite the many evidence and the guidelines’ recommendations, the quality of lipid-lowering and also the goal attainment rate is inadequate. What are the reasons of the inertia? From the patients’ side the appearance of the different side effects is a factor for decreasing their compliance. The statin intolerance is believed to occur in 10-15% of cases. Many patients complain of muscle pain when taking statins, but the actual relation with medications is significantly less common than it appears based on the patients’ symptoms. The STOMP study was designed to examine the side effect, in the statin naive patients the occurrence of myalgia in the group taking 80 mg atorvastatin was 9.4%, in the placebo group 4.6%. In clinical endpoint HOPE-3 study, the incidence of muscle pain was 5.8% in case of patients taking 10 mg rosuvastatin and 4.7% for placebo group. According to a recently presented, very well-designed, randomized, double-blind SAMSON study, 90% of complaints that occur when taking statins are not due to a drug effect. Improving the patients’ adherence might be achieved through continuous education, the use of electronic devices, and simplifying the treatment. To attain a better quality of lipid level reduction, the attitude of the medical staff related to therapy should also be optimized.