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Comment & Response |

Statins and Musculoskeletal Adverse Events—Reply

Mitchell H. Katz, MD1; Rita F. Redberg, MD, MSc2
[+] Author Affiliations
1Department of Health Services, Los Angeles County, Los Angeles, California
2Department of Medicine, University of California, San Francisco
JAMA Intern Med. 2014;174(2):302-303. doi:10.1001/jamainternmed.2013.12682.
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In Reply Dr Finkelstein asks that the Editor “advance the appropriate cautions” about the findings of Mansi et al,1 showing higher rates of musculoskeletal conditions and pain in statin users. His concern is that an unintended consequence of the publication and its associated media coverage is that patients will stop using their medication and jeopardize their health.

With publication of any article suggesting an adverse effect of a medication, there is a risk that patients will make an ill-considered decision to stop using a needed medication. However, we believe that patients and their physicians are best served by publication and discussion of adverse effects of medications. We agree that the results of any observational study, including this one, are subject to confounding. However, the study has the advantage of a large number subjects seen in a real-world setting. The recent Cochrane review of statins for primary prevention of cardiovascular disease concluded that “there was evidence of selective reporting of outcomes, and failure to report adverse events.”2 We hope that publication of this study serves to increase research on the adverse effects of statins and increases discussion between physicians and their patients about the known and potential benefits and risks of these drugs.


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February 1, 2014
Murray M. Finkelstein, PhD, MD
1Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
JAMA Intern Med. 2014;174(2):302. doi:10.1001/jamainternmed.2013.12697.
February 1, 2014
Ishak Mansi, MD; Eric M. Mortensen, MD, MSc; Christopher R. Frei, PharmD, MSc
1VA North Texas Health Care System, University of Texas Southwestern Medical Center, Dallas2Department of Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas
3College of Pharmacy, The University of Texas at Austin, Austin4Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center, San Antonio
JAMA Intern Med. 2014;174(2):303-304. doi:10.1001/jamainternmed.2013.12683.
February 1, 2014
Rene Baudrand, MD; Gordon H. Williams, MD
1Department of Endocrinology, Diabetes, and Hypertension, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2014;174(2):302. doi:10.1001/jamainternmed.2013.12705.
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