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Evaluation of impact of statin use on development of CPK elevation during daptomycin therapy.
Ann Pharmacother. 2014 Mar; 48(3):320-7.AP

Abstract

BACKGROUND

Because both daptomycin and statins may increase creatine phosphokinase (CPK) levels, the manufacturer of daptomycin suggests considering holding statins during daptomycin therapy. Published evidence suggests potential detrimental effects of withdrawing statin therapy.

OBJECTIVES

The objectives of this study were to determine the impact of concurrent statin therapy on peak CPK values, incidence of CPK elevation in patients receiving daptomycin therapy, and clinical factors associated with increased risk of developing CPK elevation.

METHODS

This was a single-center, retrospective cohort study of patients ≥18 years of age who received daptomycin for ≥72 hours and had ≥1 follow-up CPK during a 5-year period. A Kaplan-Meier curve was used to evaluate time to CPK elevation. Cox regression analyses were used to compare the risk of developing elevated CPK between 3 study groups: those receiving daptomycin alone, daptomycin with concurrent statin therapy, and statin therapy held while on daptomycin.

RESULTS

498 patients were included in the study-384 received daptomycin alone, 63 received daptomycin concurrent with statin, and 51 with statin held during daptomycin therapy. Cumulative incidence of CPK elevation was 5.1% and 12% at 7 and 14 days. Those on daptomycin and statin concurrent therapy demonstrated an approximately 2-fold risk of CPK elevation compared with those having their statin therapy held, but the overall group effect was not statistically significant (P = .17).

CONCLUSIONS

Our findings suggest that holding statin during daptomycin therapy may not be necessary, but may indicate need for increased frequency of CPK monitoring when these medications are used concurrently.

Authors+Show Affiliations

Mayo Clinic Department of Pharmacy, Rochester, MN, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24321853

Citation

Berg, Melody L., et al. "Evaluation of Impact of Statin Use On Development of CPK Elevation During Daptomycin Therapy." The Annals of Pharmacotherapy, vol. 48, no. 3, 2014, pp. 320-7.
Berg ML, Estes LL, Dierkhising RA, et al. Evaluation of impact of statin use on development of CPK elevation during daptomycin therapy. Ann Pharmacother. 2014;48(3):320-7.
Berg, M. L., Estes, L. L., Dierkhising, R. A., Curran, B., & Enzler, M. J. (2014). Evaluation of impact of statin use on development of CPK elevation during daptomycin therapy. The Annals of Pharmacotherapy, 48(3), 320-7. https://doi.org/10.1177/1060028013514377
Berg ML, et al. Evaluation of Impact of Statin Use On Development of CPK Elevation During Daptomycin Therapy. Ann Pharmacother. 2014;48(3):320-7. PubMed PMID: 24321853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of impact of statin use on development of CPK elevation during daptomycin therapy. AU - Berg,Melody L, AU - Estes,Lynn L, AU - Dierkhising,Ross A, AU - Curran,Brian, AU - Enzler,Mark J, Y1 - 2013/12/09/ PY - 2013/12/11/entrez PY - 2013/12/11/pubmed PY - 2014/11/19/medline KW - HMG Co-A reductase inhibitors KW - adverse drug reaction KW - creatine phosphokinase KW - daptomycin KW - drug interaction KW - drug safety SP - 320 EP - 7 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 48 IS - 3 N2 - BACKGROUND: Because both daptomycin and statins may increase creatine phosphokinase (CPK) levels, the manufacturer of daptomycin suggests considering holding statins during daptomycin therapy. Published evidence suggests potential detrimental effects of withdrawing statin therapy. OBJECTIVES: The objectives of this study were to determine the impact of concurrent statin therapy on peak CPK values, incidence of CPK elevation in patients receiving daptomycin therapy, and clinical factors associated with increased risk of developing CPK elevation. METHODS: This was a single-center, retrospective cohort study of patients ≥18 years of age who received daptomycin for ≥72 hours and had ≥1 follow-up CPK during a 5-year period. A Kaplan-Meier curve was used to evaluate time to CPK elevation. Cox regression analyses were used to compare the risk of developing elevated CPK between 3 study groups: those receiving daptomycin alone, daptomycin with concurrent statin therapy, and statin therapy held while on daptomycin. RESULTS: 498 patients were included in the study-384 received daptomycin alone, 63 received daptomycin concurrent with statin, and 51 with statin held during daptomycin therapy. Cumulative incidence of CPK elevation was 5.1% and 12% at 7 and 14 days. Those on daptomycin and statin concurrent therapy demonstrated an approximately 2-fold risk of CPK elevation compared with those having their statin therapy held, but the overall group effect was not statistically significant (P = .17). CONCLUSIONS: Our findings suggest that holding statin during daptomycin therapy may not be necessary, but may indicate need for increased frequency of CPK monitoring when these medications are used concurrently. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/24321853/Evaluation_of_impact_of_statin_use_on_development_of_CPK_elevation_during_daptomycin_therapy_ L2 - http://journals.sagepub.com/doi/full/10.1177/1060028013514377?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -