Among 4,016 Australian primary care patients starting statins for primary prevention, 3.5% met an electronic-record definition of intolerance (muscle symptoms plus creatine kinase testing) within two years. Female or other-gender patients had 1.5-fold higher adjusted odds (95% CI 1.0-2.2), those living in the most socioeconomically advantaged areas (IRSAD categories 8-9) had 3.4-fold higher odds, and patients with three or more selected comorbidities had 6.4-fold higher odds, though that interval was wide (2.2-18.3).
The 3.5% rate sits far below the 10-25% reported in observational studies, yet randomized trials show most muscle complaints on statins are not drug-caused. That gap suggests this definition captures only clinically investigated cases, and the associations may partly reflect who gets symptoms recognized and tested rather than who truly reacts. Advantaged patients and those with more comorbidities may simply see doctors more often, which could inflate their apparent risk. The wide comorbidity interval signals few events in that group. As a preprint, it has not been peer reviewed, and the authors themselves caution against clinical use before validation. For patients, the practical message is unchanged: persistent muscle symptoms deserve a conversation with a doctor about dose, switching agents or retesting rather than quitting statins outright. This is incremental, hypothesis-generating work, not a tool for predicting who will tolerate treatment.