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SAMSON and the Nocebo Effect: Management of Statin Intolerance

  • Lipid Abnormalities and Cardiovascular Prevention (ED Michos, Section Editor)
  • Published:
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Abstract

Purpose of Review

Statins are essential medications in the treatment of atherosclerotic cardiovascular disease; however, remain widely underutilized in large part due to concerns regarding adverse side effects. We describe the role of the nocebo effect in the perception of statin intolerance and provide management recommendations utilizing both statin and non-statin lipid-lowering therapies.

Recent Findings

The recent Self-Assessment Method for Statin side-effects Or Nocebo (SAMSON) trial demonstrated that 90% of adverse symptoms related to statins were also elicited by placebo, a powerful demonstration of the nocebo effect. Importantly, 50% of the study patients were able to successfully reinitiate statin therapy.

Summary

Statin intolerance is common and can often be managed with expectation setting and adjustment of doses and/or dosing regimens. In those who remain unable to tolerate statins, numerous alternative lipid-lowering therapies exist with strong safety and efficacy profiles.

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Authors and Affiliations

  1. Department of Medicine, Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, 1305 York Avenue, 8th Floor, New York, NY, 10021, USA

    Amrita Krishnamurthy, Rebecca Ascunce & Samuel M. Kim

  2. Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York, NY, USA

    Corey Bradley

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  1. Amrita Krishnamurthy
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Correspondence to Samuel M. Kim.

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Dr. Kim reports being on the American College of Cardiology Prevention Leadership Council. The other authors declare that they have no conflict of interest.

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Krishnamurthy, A., Bradley, C., Ascunce, R. et al. SAMSON and the Nocebo Effect: Management of Statin Intolerance. Curr Cardiol Rep 24, 1101–1108 (2022). https://doi.org/10.1007/s11886-022-01729-x

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