Statins in the Musculoskeletal Landscape - An Evidence-based Inquiry

Overview

This evidence-based inquiry course offers a comprehensive exploration of statin muscle pain and intolerance for musculoskeletal healthcare professionals.

It covers a wide range of topics, including symptoms, risk factors, types of statins, potential mechanisms, research findings, diagnostic tools, and effective management strategies. Additionally, the course delves into the controversies surrounding statin therapy, as well as the potential benefits and risks associated with the use of these medications.

Course Outline

1. Introduction and Goals to Statin Muscle Pain and Intolerance
   • Disclaimer
     
     
2. Definition and Prevalence of Statin Muscle Pain and Intolerance
   • FDA information for clinicians and patients
     
     
3. Importance of Statins
   • Benefits and risks of statin therapy
     
     
4. Symptoms and Possible Side Effects
   • Risk factors
     
     
5. Types of Statins and Dosage
   • Lipophilic
   • Hydrophilic
   • Dosage discussion
     
     
6. Testing and Diagnosis of Statin Muscle Pain and Intolerance
   • Creatine Kinase
   • Diagnostic tools
   • Statin-associated muscle symptom clinic index
   • Mayo Clinic Statin Intolerance Service
     
     
7. Nocebo Effect
   • Discussion of the nocebo effect
   • Ways to prevent the nocebo effect
     
     
8. Position Paper International Lipid Expert Panel
   • Paper findings and outcomes
     
     
9. Research
   • SAMS and low incidence reasons in research
   • STOMP Study (2013)
   • Lancet Report (2022)
   • Meta-analysis Davis et al (2021)
   • Meta-analysis Prevalence of statin intolerance Bytuci I et al (2022)
     
     
10. Mechanism Behind SAMS
    
    
11. Levels of Muscle Involvement
    • Rhabdomyolysis
    • Myalgia and Mild HyperCKemia
    • Self-Limited Toxic Statin Myopathy
    • Statin Associated Autoimmune Necrotizing Myopathy
    • Differential Diagnosis of Muscle Pain
      • Immune-mediated myopathies
      • Other possible diagnoses
      • Statins and Tendinopathy
        
        
12. Drug and Food Interaction
    
    
13. Statins in Rehabilitation
    
    
14. Case Study of a Patient with Statin Muscle Pain and Intolerance
    
    
15. Summary and Conclusions
    • Summary of key concepts covered in the course
    • Quiz
    • References

Learning Objectives

In this online course, we will:

1. Increase awareness and enhance recognition of statin intolerance in musculoskeletal patients.
2. Gain knowledge about the risk factors linked to Statin-Associated Muscle Symptoms (SAMS).
3. Identify the signs and symptoms of myositis/myopathy.
4. Develop a deeper understanding of the physiological processes involved in SAMS and explore various tests available for confirmation.

Audience

This online course is for medical professionals and rehabilitation professionals including physiotherapitss.