Statin-Associated Allergic and Cutaneous Adverse Reactions: A Systematic Review
DOI:
https://doi.org/10.36557/2674-8169.2026v8n6p1496-1511Keywords:
Hydroxymethylglutaryl-CoA Reductase Inhibitors. Drug Hypersensitivity. Urticaria. Angioedema. Drug Eruptions.Abstract
Statins (HMG-CoA reductase inhibitors) are among the most widely prescribed drugs globally; however, statin-associated allergic and cutaneous reactions remain underreported and poorly characterised. This study aimed to systematically identify, describe, and quantify the spectrum of such reactions, characterising implicated agents, severity, proposed immunological mechanisms, and clinical outcomes. A systematic review was conducted following PRISMA 2020 guidelines, searching PubMed/MEDLINE, Cochrane Library, and LILACS/BVS (May 2026), by two independent reviewers (κ=0.673; PROSPERO: CRD420261391101). Of 296 records identified, 25 studies were included (22 case reports, 2 case series, 1 observational study; 14 countries). Atorvastatin was the most frequently implicated agent (n=10; 40.0%), followed by rosuvastatin (n=5; 20.0%) and simvastatin (n=4; 16.0%). Angioedema was the most common reaction (n=6; 24.0%), followed by drug eruptions (20.0%) and autoimmune/systemic reactions (16.0%). Severe reactions accounted for 40.0% of cases. Complete resolution after drug discontinuation was documented in 88.0%, with an overall resolution rate of 96.0%. Statins can induce a broad and clinically significant spectrum of allergic and cutaneous reactions; prompt drug withdrawal is the cornerstone of management.
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