The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Objective: To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods: We systematically searched 5 electronic databases for placebo-controlled RCTs through January...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454824000043 |
| _version_ | 1797226623159762944 |
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| author | Laura A. Mangone, MS Oh Sung Kwon, PhD Blair T. Johnson, PhD Yin Wu, PhD Linda S. Pescatello, PhD |
| author_facet | Laura A. Mangone, MS Oh Sung Kwon, PhD Blair T. Johnson, PhD Yin Wu, PhD Linda S. Pescatello, PhD |
| author_sort | Laura A. Mangone, MS |
| collection | DOAJ |
| description | Objective: To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods: We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed. Results: Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=−0.18; 95% CI, −0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, −0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=−1.84; 95% CI, −2.28 to −1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%). Conclusion: Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training. |
| first_indexed | 2024-03-07T23:51:57Z |
| format | Article |
| id | doaj.art-5950bcc366f8480c9f28985a758d4a94 |
| institution | Directory Open Access Journal |
| issn | 2542-4548 |
| language | English |
| last_indexed | 2024-04-24T14:27:51Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| spelling | doaj.art-5950bcc366f8480c9f28985a758d4a942024-04-03T04:27:11ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482024-04-0182131142The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsLaura A. Mangone, MS0Oh Sung Kwon, PhD1Blair T. Johnson, PhD2Yin Wu, PhD3Linda S. Pescatello, PhD4Department of Kinesiology, University of Connecticut, Storrs, CT; Correspondence: Address to Laura Mangone, MS. Department of Kinesiology, University of Connecticut, 1376 Storrs Road, U-4163, Room #204 Storrs, CT 06269.Department of Kinesiology, University of Connecticut, Storrs, CT; UConn Center on Aging and Department of Orthopedic Surgery, University of Connecticut, School of Medicine, Farmington, CTDepartment of Psychological Sciences, University of Connecticut, Storrs, CTDepartment of Research, Hartford Hospital/HealthCare, Hartford, CTDepartment of Kinesiology, University of Connecticut, Storrs, CTObjective: To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods: We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed. Results: Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=−0.18; 95% CI, −0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, −0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=−1.84; 95% CI, −2.28 to −1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%). Conclusion: Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training.http://www.sciencedirect.com/science/article/pii/S2542454824000043 |
| spellingShingle | Laura A. Mangone, MS Oh Sung Kwon, PhD Blair T. Johnson, PhD Yin Wu, PhD Linda S. Pescatello, PhD The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
| title | The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full | The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_fullStr | The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_full_unstemmed | The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_short | The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials |
| title_sort | role of exercise in statin associated muscle symptoms outcomes a systematic review and meta analysis of randomized controlled trials |
| url | http://www.sciencedirect.com/science/article/pii/S2542454824000043 |
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