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Self-medication to lower LDL cholesterol and to treat statin-associated muscle symptoms in patients with statin intolerance

Stürzebecher PE, Katzmann JL, Gouni-Berthold I, Müller-Kozarez I, Mateev C, Frenzel O, Weingärtner O, Kassner U et al.

Journal of clinical lipidology, 2025

1,111 participants

Abstract

BACKGROUND: Self-medication with supplements or over-the-counter drugs is very frequent despite limited evidence on efficacy and safety. Patients with statin intolerance (SI) may be prone to self-medication to lower low-density lipoprotein cholesterol (LDL-C) and to treat statin-associated muscle symptoms (SAMS).

OBJECTIVE: To evaluate the use and predictors of self-medication in the prospective, multicenter Statin Intolerance Registry at baseline.

METHODS AND RESULTS: Among 1111 patients (mean age 66.1 [9.9] years, 57.7% female), 67.2% reported use of self-medication to lower LDL-C (43.8%, n = 487) or to treat SAMS (53.2%, n = 592). The most frequent self-medications used to treat SAMS were pain medication (31.1%), electrolytes (25.9%), and vitamin D (23.0%). The most commonly used supplements to lower LDL-C were omega-3 fatty acids (28.8%) and ginger/garlic (17.6%). Reporting self-medication was strongly associated with depressive symptoms (patient health questionnaire [PHQ-9] score) and experience of negative statin-related information. Use of self-medication to lower LDL-C was not associated with lower LDL-C levels. More than half (54.0%) of the patients reported negative statin-related influence from other people (mainly family and friends), the media, or both, which was associated with more frequent self-medication but similar LDL-C concentrations.

CONCLUSIONS: The majority of patients with SI used self-medication to lower LDL-C or to treat SAMS. Self-medication was…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,111 participants or records.

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