Monday, November 26, 2012

Muscle Pains and Statins

 I have attached an abstract published by PUB Med this morning.  Their finding  are about the same as my own clinical experience. Notice that they defined myopathy as muscle symptoms and an elevated lab test , CPK( creatine kinase). Many people have mild muscle aches without abnormal lab test and these symptoms usually these symptoms subside over time. Myopathy risk increases with higher doses of statins. I have attached a link to a previous post regarding Zocor( simvastatin )

Simvastatin 80 mg FDA report

I have also attached links to previous post regarding myopathy and Statins below.


 2012 Oct;30(5):e212-8. doi: 10.1111/j.1755-5922.2011.00267.x. Epub 2011 Apr 1.

Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge.

Source

Department of Clinical Biochemistry and Metabolic Medicine, University Hospital Lewisham, London, UK. efung@nhs.net

Abstract

INTRODUCTION:

Statin myopathy is a generally encountered side effect of statin usage. Both muscle symptoms and a raised serum creatine kinase (CK) are used in case definition, but these are common manifestations of other conditions, which may not be statin related. Statin rechallenge assuming no contraindication in selected cases is an option before considering a different class of lipid-lowering agent.

AIMS:

We aim to characterize retrospectively the patients referred to our Lipid Clinic with a diagnosis of statin myopathy. The tolerability of different statins was assessed to determine a strategy for rechallenging statins in such patients in the future.

RESULTS:

Patients with statin myopathy constitute 10.2% of our Lipid Clinic workload. They are predominantly female (62.0%), Caucasian (63.9%), with a mean age of 58.3 years and mean body mass index (BMI) of 29.3 kg/m(2). The serum CK and erythrocyte sedimentation rate (ESR) were statistically higher compared to patients with statin intolerances with no muscular component or CK elevations. Secondary causes of statin myopathy were implicated in 2.7% of cases. Following statin myopathy to simvastatin we found no statistical difference between the tolerability rates between atorvastatin, rosuvastatin, pravastatin, and fluvastatin. Fibrates, cholestyramine, and ezetimibe were statistically better tolerated in these patients.

CONCLUSIONS:

Statin rechallenge is a real treatment option in patients with statin myopathy. Detailed history and examination is required to exclude muscle diseases unrelated to statin usage. In patients developing statin myopathy on simvastatin, we did not find any statistical difference between subsequent tolerability rates to rosuvastatin, pravastatin, and fluvastatin.
© 2011 Blackwell Publishing Ltd.


No comments:

Post a Comment

Your comments and questions are appreciated. David Calder,MD