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Vitamin D fails to reduce statin-associated muscle pain

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Patients taking statins to lower high cholesterol levels often complain of muscle pain, which can lead them to stop taking highly effective medications and increase their risk of heart attack and stroke.

Some clinicians recommend vitamin D supplements to relieve muscle soreness in patients taking statins, but a new study by scientists at Northwestern, Harvard, and Stanford University suggests that the vitamin This indicates that it does not appear to have any real impact.

the study Published in JAMA Cardiology on November 23rd.

Although nonrandomized studies have reported that vitamin D is an effective treatment for statin-related muscle symptoms, the first randomized study to examine the effect of vitamin D on statin-related muscle symptoms The new study, which is a clinical trial, was large enough to rule out significant benefits.

In a randomized, double-blind trial, 2,083 participants took 2,000 units of vitamin D supplements daily or a placebo. The study found that participants in both categories were equally likely to develop muscle symptoms and discontinue statin therapy.

30-35 million

Approximately 30 to 35 million Americans are prescribed statins to lower cholesterol

At 4.8 years of follow-up, statin-related myalgia was reported by 31% of vitamin D-assigned participants and 31% of placebo-assigned participants.

“With statin-related muscle symptoms being the primary reason so many patients stop taking statin drugs in our clinics and across the country, there is great hope that vitamin D will work. ,” said the senior author. Dr. Neil Stone, is a professor of medicine in cardiology and preventive medicine at Northwestern University Feinberg School of Medicine and a cardiologist at Northwestern Medicine. “It is therefore very disappointing that vitamin D did not pass the rigorous test. It is important.”

Statins and vitamin D supplements are the two most commonly used drugs by American adults. About 30 million to 35 million Americans are prescribed statins, and about half of the population over the age of 60 takes vitamin D supplements.

“We utilized a large, placebo-controlled, randomized trial to test whether vitamin D can reduce statin-related muscle symptoms and help patients stay on their statins. Mark Flackie, Professor of Health Policy and Cardiovascular Medicine at Stanford University. “The placebo control in this study was important because if people think vitamin D reduces muscle soreness, even if vitamin D has no specific effect, it makes them feel better while taking it. Because it might.”

The trial was a substudy within a larger clinical trial

2,083 patients were Vitamin D and Omega 3 Test (VITAL), It randomized nearly 26,000 participants to double-blind vitamin D supplementation to determine whether it prevented cardiovascular disease and cancer. This gave researchers a unique opportunity to test whether vitamin D reduces muscle symptoms in participants who started statin therapy during the follow-up period of her larger VITAL trial. . The average age of study participants was 67, and 51% were female.

“Randomized clinical trials are important because many very good ideas don’t work as expected when tested,” Hlatky said. “Statistical association does not prove causation. Low levels of vitamin D are associated with many medical problems, but even if people are given vitamin D, these problems are common. has been found not to resolve

For patients with statin-related muscle pain

Dr. Stone says the key to understanding patients who are having trouble with statins is to analyze other medications they are taking, determine if they are related to metabolic or inflammatory conditions, and ensure they are properly hydrated. Counseling about the ability and pointed out that the important thing is to talk about it.”Pill Anxiety”.

“For those who have problems with statins, systematic evaluation by a physician with experience in dealing with these problems is still very important,” Stone said.

The idea for this substudy came from a conversation between study co-author Pedro Gonzalez, Ph.D., then a resident at Northwestern Memorial Hospital, and Dr. Stone, who runs a large lipid clinic at Northwestern University.

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