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

Regional distribution or pattern:
Symmetric hip flexors or thigh aches
Symmetric calf aches
Symmetric upper proximal aches
Nonspecific asymmetric, intermittent

Temporal pattern:
Symptoms onset < 4 weeks
Symptoms onset 4-12 weeks
Symptoms onset >12 weeks

Dechallenge:
Improves upon withdrawal (< 2 weeks)
Improves upon withdrawal (2-4 weeks)
Does not improve upon withdrawal (> 4 weeks)

Challenge:
Same symptoms reoccur upon rechallenge < 4 weeks
Same symptoms reoccur upon rechallenge 4-12 weeks




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 aches3
Symmetric calf aches2
Symmetric upper proximal aches2
Nonspecific asymmetric, intermittent1
Temporal pattern 
Symptoms onset <4 weeks3
Symptoms onset 4-12 weeks2
Symptoms onset >12 weeks1
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 weeks3
Same symptoms reoccur upon rechallenge 4-12 weeks1
 
Statin myalgia clinical index score  
Probable9-11
Possible7-8
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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