To help lower a patient’s blood cholesterol levels, doctors commonly prescribes a drug called a statin. Statins block the action of a chemical in the liver necessary for making cholesterol, and inhibit an enzyme called HmG-CoA reductase. They are prescribed all over the world, with 72 million people in the United States, 12-17 million in the United Kingdom, and millions around the world eligible to take them. Unfortunately, there are some uncomfortable or even painful side effects associated with statins. Taking statins, many patients report, causes them to get muscle spasms among other side effects. Until recently, the medical community largely overlooked multiple claims of these side effects by patients.
However, a new Cleveland Clinic study that was funded by Amgen, has confirmed what patients have been complaining about all along: that taking statins increases the risk for developing muscle spasms. The study, which included over 500 patients, was unique in that it focused on people who reported they were intolerant to statins. For the first part of the study, patients took either a sugar pill or a statin. Of the patients who took the statin, 42% experienced muscle pain or weakness, and 61% were at an increased risk of muscle damage.
The second part of the study tested non-statin drugs that lowered cholesterol. Participants in the study took either an oral drug or an injectable drug. The injectable drug, a PCSK9 inhibitor produced by Amgen called evolocumab, trade name Repatha, displayed significant results, with patients who taking it experiencing a 52 to 54% reduction in the levels of bad cholesterol.
Dr. Steven Nissen, who administered the trial, said that because evolocumab lowered LDL cholesterol in patients without causing muscle symptoms, “the study has an important implication for both guidelines and regulatory policy, because it provides strong evidence that muscle-related statin intolerance is a real and reproducible phenomenon."
While studies have proven the drugs to be effective, the cost for the non-statins is high, with the price for many of these drugs coming in at over $14,000 per year. On the other hand, the price for statins is only a few hundred dollars per year.