Longevity Briefs: Most Statin Side-Effects Could Be Due To The ‘Nocebo Effect’

Posted on 17 November 2020

Longevity briefs provides a short summary of novel research in biology, medicine, or biotechnology that caught the attention of our researchers in Oxford, due to its potential to improve our health, wellbeing, and longevity.


Why is this research important: Statins are cholesterol-lowering drugs that can be highly effective at preventing heart attacks and strokes in certain people. Most people tolerate statins well, but some people experience various side effects, with the most common being muscle aches. This causes some people who could greatly benefit from taking statins to abandon their treatment.

What did the researchers do: Researchers at Imperial College London recruited 60 people who had previously stopped taking statins due to side effects. Each patient was given 4 bottles containing atorvastatin, 4 containing identical-looking placebo pills, and 4 empty bottles. They were instructed to take pills from one of these bottles each month in a randomly pre-determined order, and record the severity of their side effects each day on their smartphones.

Key takeaway(s) from this research: 49 of the 60 participants completed the trial without missing any months. Statistical analysis revealed a nocebo ratio of 0.9, meaning that 90% of the reported symptoms were estimated to be due due to the act of taking a pill, rather than being caused by the statins themselves. Researchers also observed that of the 71 months in which a patient chose to stop treatment due to side effects, 31 were placebo months.

Shown are mean symptom scores for the 49 patients who completed all 12 months of the trial (left) and those for the 11 patients who did not complete all 12 months (right). Each circle represents a single month for each patient. Symptoms were reported daily, and the mean symptom score was calculated for the month regardless of whether the patient discontinued the assigned bottle at any time during that month.
N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects | NEJM. (2020). New England Journal Of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMc2031173

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N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects: DOI: 10.1056/NEJMc2031173

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