Therapy options · Anna Keller, 47
Therapy options

Lowering her LDL, the options in order

Anna Keller, 47 · 16 September 2026 · Signed, in the chart

In order, with the evidence under each

1Atorvastatin 20 mg in the eveningAppliesApproved for this use

A different statin from the simvastatin she stopped, at a moderate dose. Her aches of 2024 fit statin-associated muscle symptoms with a CK below four times the upper limit, the pattern in which the consensus advises a second attempt.

CTT meta-analysis, 27 randomised trials, 174,149 participantsversus placebo or a less intensive statin

Major vascular events per 1 mmol/l of LDL
RR 0.79 (0.77–0.81)
Muscle pain or weakness, statin versus placebo
27.1 % versus 26.6 %
Population studied
Adults with and without vascular disease. The analysis reports people with a five-year risk below 10 % separately.
Where she differs
The trials did not select people with earlier muscle symptoms. For that question, the blinded trials stand in the evidence answer.
Data maturity
Individual participant data with about five years of follow-up. The pooled analysis of muscle symptoms followed in 2022.
Guideline
ESC/EAS 2019: at moderate risk an LDL goal below 100 mg/dl, with a statin as the first step. EAS consensus 2015: after muscle symptoms, a rechallenge with a different statin. ESC/EAS 2019

If the aches come back, check the CK and pause the tablet. Do not raise the dose into the symptoms.

Before it could startCK before the start96 U/l on 8 May 2026Liver values before the startALT 41 U/l on 8 May 2026. It fits the steatosis and is no reason to wait.Her medication checkedRamipril and sertraline, no interaction
2Rosuvastatin 5 mgAppliesApproved for this use

The second statin if atorvastatin brings the aches back. It lowers LDL at a small dose, which keeps the dose low for a patient who has reacted once.

JUPITER, 17,802 randomised, rosuvastatin 20 mgversus placebo

Primary endpoint, hazard ratio (95 % CI)
0.56 (0.46–0.69)
LDL reduction
50 %
Population studied
Men and women without cardiovascular disease, with an LDL below 130 mg/dl and an hsCRP of 2 mg/l or more.
Where she differs
Her LDL is higher than the trial allowed, and the dose studied was four times the one proposed here.
Data maturity
Stopped early after a median of 1.9 years for benefit, which tends to overstate the size of an effect.
Guideline
ESC/EAS 2019: statins as the first step; the choice of statin and dose follows tolerance and the distance to the goal. ESC/EAS 2019
3Ezetimibe, then bempedoic acidIf a second statin also failsApproved, bempedoic acid for people who cannot take a statin

Neither is a statin. Ezetimibe lowers the uptake of cholesterol from the gut. Bempedoic acid acts one step before the statins and is activated only in the liver, which is why it was studied in people who could not take a statin.

CLEAR Outcomes, 13,970 randomised, bempedoic acid 180 mgversus placebo

Major cardiovascular events, hazard ratio (95 % CI)
0.87 (0.79–0.96)
LDL reduction beyond placebo
21.1 percentage points
Gout
3.1 % versus 2.1 %
Gallstones
2.2 % versus 1.2 %
Population studied
People who could not take a statin, with cardiovascular disease or at high risk of it. About 30 % were in primary prevention.
Where she differs
Her risk is lower than that of the trial population, so the absolute benefit for her would be smaller.
Data maturity
Event-driven, median follow-up 40.6 months.
Guideline
ESC/EAS 2019: ezetimibe if the goal is not reached on the tolerated statin dose, or alone if no statin is tolerated. ESC/EAS 2019

Bempedoic acid raises uric acid. One value before the start is worth it in anyone with gout in the history.

Checked against everything she takes

Her medication list of 16 September, read against the product information of the option ranked first.

No actionAtorvastatin × ramiprilNo shared metabolic route.Continue both unchanged.
No actionAtorvastatin × sertralineNo clinically relevant interaction.Continue both unchanged.
WatchAtorvastatin × clarithromycinA strong CYP3A4 inhibitor. Not on her list today.If a macrolide is ever prescribed for an infection, pause atorvastatin for the course.

Read from her own record, not from the guideline

  • Simvastatin 20 mg, March 2024: muscle aches in both thighs, CK 210 U/lBelow four times the upper limit and gone within two weeks of stopping. That is what puts a second statin first.
  • LDL 162 mg/dl, father with a myocardial infarction at 58From 162 to below 100 mg/dl is a reduction of about 40 %, the range of a moderate statin dose. The blood test after eight weeks shows whether it closes the distance.
  • Lipoprotein(a) not yet measuredA high value would move her risk category, and with it the goal.

Sources

ESC/EAS 2019Lancet 2012, CTTN Engl J Med 2008, JUPITERN Engl J Med 2023, CLEAR OutcomesVisit 14.03.2024Lab 08.05.2026

Built from the studies behind each option and from this chart: the muscle aches of 2024, the LDL, the family history and the medication list. Where a study population differs from her, that sentence stands above the numbers. The order is a proposal with its reasons visible; the decision is the physician's.