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Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge.
Cardiovasc Ther. 2012 Oct; 30(5):e212-8.CT

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.

Authors+Show Affiliations

Department of Clinical Biochemistry and Metabolic Medicine, University Hospital Lewisham, London, UK. efung@nhs.netNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21884002

Citation

Fung, En C., and Martin A. Crook. "Statin Myopathy: a Lipid Clinic Experience On the Tolerability of Statin Rechallenge." Cardiovascular Therapeutics, vol. 30, no. 5, 2012, pp. e212-8.
Fung EC, Crook MA. Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge. Cardiovasc Ther. 2012;30(5):e212-8.
Fung, E. C., & Crook, M. A. (2012). Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge. Cardiovascular Therapeutics, 30(5), e212-8. https://doi.org/10.1111/j.1755-5922.2011.00267.x
Fung EC, Crook MA. Statin Myopathy: a Lipid Clinic Experience On the Tolerability of Statin Rechallenge. Cardiovasc Ther. 2012;30(5):e212-8. PubMed PMID: 21884002.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge. AU - Fung,En C, AU - Crook,Martin A, Y1 - 2011/04/01/ PY - 2011/9/3/entrez PY - 2011/9/3/pubmed PY - 2013/1/30/medline SP - e212 EP - 8 JF - Cardiovascular therapeutics JO - Cardiovasc Ther VL - 30 IS - 5 N2 - 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. SN - 1755-5922 UR - https://www.unboundmedicine.com/medline/citation/21884002/Statin_myopathy:_a_lipid_clinic_experience_on_the_tolerability_of_statin_rechallenge_ L2 - https://doi.org/10.1111/j.1755-5922.2011.00267.x DB - PRIME DP - Unbound Medicine ER -