The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI)

Score	Range of points	Statin myalgia clinical index score
0	0	0

Determination of the clinical index of statin-associated muscle symptoms

Clinical symptoms (new or increased unexplained muscle symptoms)	Points
Regional distribution/pattern
Symmetric hip flexors/thigh aches	3
Symmetric calf aches	2
Symmetric upper proximal aches	2
Nonspecific asymmetric, intermittent	1
Temporal pattern
Symptoms onset <4 weeks	3
Symptoms onset 4-12 weeks	2
Symptoms onset >12 weeks	1
Dechallenge
Improves upon withdrawal (<2 weeks)	2
Improves upon withdrawal (2-4 weeks)	1
Does not improve upon withdrawal (>4 weeks)	0
Challenge
Same symptoms reoccur upon rechallenge <4 weeks	3
Same symptoms reoccur upon rechallenge 4-12 weeks	1

Statin myalgia clinical index score
Probable	9-11
Possible	7-8
Unlikely	<7

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Source:
The Statin-Associated Muscle Symptom Clinical Index (SAMS-CI): Revision for Clinical Use, Content Validation, and Inter-rater Reliability.Rosenson RS, Miller K, Bayliss M, Sanchez RJ, Baccara-Dinet MT, Chibedi-De-Roche D, Taylor B, Khan I, Manvelian G, White M, Jacobson TA.Cardiovasc Drugs Ther. 2017 Apr;31(2):179-186. doi: 10.1007/s10557-017-6723-4.PMID: 28421332

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Date of assessment

≥1 of the following (A or B)

A. Clonal bone marrow plasma cells ≥10%

B. Biopsy-proven bony or extramedullary plasmacytoma

• C1. End organ damage attributable to underlying plasma cell disorder (≥1 of the following): *

o Hypercalcemia (Serum calcium >1 mg/dL (>0.25 mmol/L) higher than upper limit of normal or >11 mg/dL (>2.75 mmol/L))

o Renal insufficiency (Creatinine clearance<40 mL per min or serum creatinine >2 mg/dL (177 μmol/L))

o Anemia (Hemoglobin >2 g/dL (20 g/L) below lower limit of normal

o Bone lesions (≥1 osteolytic lesion on skeletal x-ray

• C2. ≥1 of the following biomarkers of malignancy: *

o Clonal bone marrow plasma cells ≥60%

o Involved:uninvolved sFLC ratio ≥100

o >1 focal lesion on MRI

Result

Diagnostic result

Negative. Not positive for multiple myeloma by IMWG criteria

Diagnostic result

Positive for multiple myeloma by IMWG criteria

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