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Statins safe in muscle pain

GPs should not routinely stop statin treatment in patients who develop muscle pain, a new review suggests.

Statins have been linked to muscle problems and many GPs automatically stop treatment in patients with muscle pain while they measure creatine kinase levels to detect myopathy.

But a review published early online in The Lancet claims muscle pain is common in middle-aged patients and unlikely to be a result of statin treatment.

Myopathy occurs in fewer than one in 10,000 patients at standard doses, according to review author Dr Jane Armitage, reader in clinical epidemiology at the University of Oxford's clinical trial service unit.

'Routine measurement of creatine kinase is not helpful for detecting the rare cases of myopathy at statin standard doses,' she said.

The review concluded measurement should be restricted to patients with muscle weakness or bilateral proximal muscle pain, those with potential drug interactions and those on high-dose statin therapy.

More generally, Dr Armitage concluded statins were safe, well-tolerated and had a proven impact on cardiovascular disease.

But Dr Rubin Minhas, a GP in Gillingham, Kent, and member of the Primary Care Cardiovascular Society, said it was not realistic to apply the research findings to clinical practice.

He said: 'In general practice, patients frequently present in atypical ways and GPs need to have a relatively safe threshold of satisfaction before excluding a potentially serious diagnosis.'

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