5. Conclusions
dynapenia, sarcopenia
DRUG WITHDRAWAL, MUSCLE DISEASE, SECONDARY, SARCOPENIA
Whether or not our study population suffered from “true” SAMS or nocebo effects, our data indicate that participants who self-reported SAMS had improved physical function concurrent with decreased subjective symptom intensity following drug withdrawal. Although the negative impacts of statins on muscle function appear small, these could nonetheless have real and substantive effects in certain patients or patient populations. For example, in patients who have experienced sarcopenia or dynapenia, such as the frail elderly or others suffering from various muscle diseases, an additional loss of even a small portion of their functional physical capacity could contribute to important loss of independence and health-related quality of life (HRQoL). We suggest that our results should be considered by clinicians in the evaluation and follow-up of treatment with statins in such populations. Even for healthier populations, such as the patients in primary prevention of the present study (who maintained low-to-moderate Framingham risk scores even after statin withdrawal), clinical teams should consider the potential benefits of ending statin therapy or switching to another treatment option in those reporting significant SAMS as this could impact their physical function. Overall, we suggest that careful follow-up of SAMS and their impacts on patient perceived and objective muscle function are warranted so that the clinicians can adjust their advice and prescription to avoid loss of function while maintaining compliance with treatment to effectively prevent the occurrence of CVD.Clearly, the present results need to be validated or recreated in other studies. More prospective data are needed, perhaps in the context of a randomized double-blinded study. Given the relative ease with which handgrip strength can be measured, the present data certainly warrant future studies on its potential clinical value in assessing functional changes with statin use in various populations. Furthermore, these results need to be examined in other statin-using populations, for example older patients or those in secondary prevention. It also remains of great interest to further efforts to better identify “true” SAMS sufferers and to assess whether functional impacts are greater in this group. Finally, while we focus in this report on objective measures of muscle functions, other impacts of self-reported SAMS such as those on HRQoL need further study.