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A series of N-of-1 RCTs found no overall effect of 20mg Atorvastatin on muscle symptoms when compared to placebo.

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Emily Herrett 1, Elizabeth Williamson 2, Kieran Brack 3, Alexander Perkins 4, Andrew Thayne 4, Haleema Shakur-Still 4, Ian Roberts 4, Danielle Prowse 4, Danielle Beaumont 4, Zahra Jamal 4, Ben Goldacre 5, Tjeerd van Staa 6, Thomas M MacDonald 7, Jane Armitage 8, Michael Moore 9, Maurice Hoffman 10, Liam Smeeth 1,*

1 Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
2 Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
3 Liver Research, King’s College Hospital, London, UK
4 Clinical Trials Unit, London School of Hygiene & Tropical Medicine, London, UK
5 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
6 Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, UK
7 Medicines Monitoring Unit, School of Medicine, University of Dundee, Dundee, UK
8 Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
9 School of Primary Care and Population Sciences, University of Southampton, Southampton, UK
10 , London, UK
* Corresponding author Email: Liam.smeeth@lshtm.ac.uk

Declared competing interests of authors: Liam Smeeth reports grants from the Wellcome Trust, the Medical Research Council (MRC), the National Institute for Health Research (NIHR), GlaxoSmithKline plc (Brentford, UK), British Heart Foundation and Diabetes UK outside the submitted work. Liam Smeeth is also a trustee of the British Heart Foundation. Thomas M MacDonald reports grants and personal fees from Novartis International AG (Basel, Switzerland), Pfizer Inc. (New York, NY, USA) and Menarini (Florence, Italy), grants from Ipsen (Paris, France) and personal fees from Takeda (Tokyo, Japan) outside the submitted work. Jane Armitage reports grants from the UK MRC, the British Heart Foundation and Cancer Research UK during the conduct of the study, and grants from The Medicines Company (Parsippany-Troy Hills, NJ, USA) outside the submitted work. Ian Roberts reports grants from NIHR during the conduct of the study and membership of the clinical trials units funded by NIHR. Haleema Shakur-Still reports grants from the NIHR Health Technology Assessment (HTA) programme during the conduct of the study and membership of the clinical trials units funded by NIHR. Ben Goldacre has received research funding from the Laura and John Arnold Foundation, the Wellcome Trust, the NIHR Oxford Biomedical Research Centre, the NHS NIHR School of Primary Care Research, the Mohn Westlake Foundation, Health Data Research UK, the Good Thinking Foundation, the Health Foundation and the World Health Organization. He also receives personal income from speaking and writing for lay audiences on the misuse of science and is writing a book for lay readers summarising the evidence on statins. Michael Moore was the chairperson of the Trial Steering Committee, which was an unpaid position ratified by the funder to provide independent advice to the trial team and to the funder. There was no expectation of authorship resulting from this position. The study team has invited authorship following completion of data collection and analysis based on the input of the chairperson into the study design, conduct and evaluation of the study findings.

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