The most common adverse events of statins are elevated liver enzymes without reports of liver failure and muscle symptoms with rare reports of rhabdomyolysis. A meta-analysis by Silva et al. (2007) showed high-dose simvastatin and atorvastatin are associated with more adverse events (OR: 1.44, 95% CI: 1.33 1.55) and more discontinuation due to adverse events (OR: 1.28, 95% CI: 1.18 1.39) than lower dosed statins.[54] Moreover, it showed more LFT and creatine kinase (CK) abnormalities in the higher dose group. A meta-analysis of 17 RCTs limited to high-dose atorvastatin, Li et al. (2016), showed a higher risk for liver transaminase elevation (RR: 4.59, 95% CI: 3.26 6.48) and discontinuation due to adverse events (RR: 1.29, 95% CI: 1.17 1.42) versus placebo or lower dose atorvastatin but no increases in CK, myalgia, or rhabdomyolysis.[55] Although a previous analysis by the Cholesterol Treatment Trialists (CTT) showed that high-dose statins slightly increase the risk of rhabdomyolysis, this increase was limited to simvastatin at 80 mg daily, which is no longer recommended by the FDA.[56] A meta-analysis by Engeda et al. (2019) shows that high-dose statins increase the risk of DM compared to placebo with a number needed to harm (NNH) of 208 over four years with no increased risk with lower statin doses.[48] In the JUPITER trial, the NNH for DM was nearly identical to the NNT to reduce all-cause mortality.[47] A meta-analysis by Wang et al. (2017) showed an increase in incident DM with any statin (OR: 1.11, 95% CI: 1.03 1.2) with high-dose statins conferring more risk (OR: 1.18, 95% CI: 1.10 1.28, NNH=130 over four years).[57] These findings are also supported by a meta-analysis, Preiss et al. 