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Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy on Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study.
Infect Dis Ther. 2014 Dec; 3(2):225-33.ID

Abstract

INTRODUCTION

The prescribing information for daptomycin recommends discontinuing statin therapy during receipt of daptomycin. The literature supporting this recommendation is sparse. The objectives of this study were to examine the impact of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) on creatine phosphokinase (CPK) elevations and mortality among patients receiving daptomycin therapy.

METHODS

A retrospective cohort study was performed among daptomycin recipients in the Upstate New York Veterans' Healthcare Administration from September 15, 2003 to July 1, 2013. Inclusion criteria were: (1) daptomycin for ≥48 h, (2) availability of baseline CPK value and (3) >1 CPK level measurement taken while on therapy. The following were extracted from medical records: demographics, comorbidities, laboratory data, medication history (daptomycin, statins and concomitant drugs known to increase CPK), Acute Physiology and Chronic Health Evaluation (APACHE)-II score and vital status at 30 days. The exposure of interest was use of statins. The primary outcome was CPK elevation defined as a CPK value ≥3 times the upper limit of normal (ULN) if baseline CPK was normal, and ≥5 times ULN if baseline CPK was elevated. The secondary outcome was death within 30 days of commencing daptomycin.

RESULTS

A total of 233 patients were included in this analysis. Among these patients, 53 received concomitant statin therapy. Most baseline clinical characteristics were similar between statin recipients and non-recipients. Five (2.1%) patients experienced a CPK elevation; 3/53 (5.7%) were statin recipients and 2/180 (1.1%) received daptomycin alone (p = 0.08). All patients with CPK elevations had normal baseline CPK values. No effect modification was observed by use of other concomitant medications known to increase CPK values. Death was observed more frequently among statin non-recipients (17.2%) than recipients (9.4%).

CONCLUSIONS

Among patients receiving daptomycin, no significant difference was observed in frequency of CPK elevation between statin recipients and non-recipients.

Authors+Show Affiliations

Samuel S. Stratton VA Medical Center, Albany, NY, USA.Samuel S. Stratton VA Medical Center, Albany, NY, USA.Samuel S. Stratton VA Medical Center, Albany, NY, USA.Pharmacy Practice Department, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY, 12208, USA.Pharmacy Practice Department, Albany College of Pharmacy and Health Sciences, 106 New Scotland Avenue, Albany, NY, 12208, USA. nimish.patel@acphs.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25245515

Citation

McConnell, Heather L., et al. "Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy On Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study." Infectious Diseases and Therapy, vol. 3, no. 2, 2014, pp. 225-33.
McConnell HL, Perris ET, Lowry C, et al. Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy on Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study. Infectious diseases and therapy. 2014;3(2):225-33.
McConnell, H. L., Perris, E. T., Lowry, C., Lodise, T., & Patel, N. (2014). Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy on Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study. Infectious Diseases and Therapy, 3(2), 225-33. https://doi.org/10.1007/s40121-014-0041-y
McConnell HL, et al. Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy On Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study. Infectious diseases and therapy. 2014;3(2):225-33. PubMed PMID: 25245515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Concomitant 3-Hydroxy-3-Methyl-Glutaryl-CoA Reductase Inhibitor Therapy on Creatine Phosphokinase Levels and Mortality Among Patients Receiving Daptomycin: Retrospective Cohort Study. AU - McConnell,Heather L, AU - Perris,Elizabeth T, AU - Lowry,Colleen, AU - Lodise,Thomas, AU - Patel,Nimish, Y1 - 2014/09/23/ PY - 2014/07/09/received PY - 2014/9/24/entrez PY - 2014/9/24/pubmed PY - 2014/9/24/medline KW - Daptomycin KW - Mortality KW - Myopathy KW - Outcomes KW - Statins KW - Toxicity SP - 225 EP - 33 JF - Infectious diseases and therapy VL - 3 IS - 2 N2 - INTRODUCTION: The prescribing information for daptomycin recommends discontinuing statin therapy during receipt of daptomycin. The literature supporting this recommendation is sparse. The objectives of this study were to examine the impact of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) on creatine phosphokinase (CPK) elevations and mortality among patients receiving daptomycin therapy. METHODS: A retrospective cohort study was performed among daptomycin recipients in the Upstate New York Veterans' Healthcare Administration from September 15, 2003 to July 1, 2013. Inclusion criteria were: (1) daptomycin for ≥48 h, (2) availability of baseline CPK value and (3) >1 CPK level measurement taken while on therapy. The following were extracted from medical records: demographics, comorbidities, laboratory data, medication history (daptomycin, statins and concomitant drugs known to increase CPK), Acute Physiology and Chronic Health Evaluation (APACHE)-II score and vital status at 30 days. The exposure of interest was use of statins. The primary outcome was CPK elevation defined as a CPK value ≥3 times the upper limit of normal (ULN) if baseline CPK was normal, and ≥5 times ULN if baseline CPK was elevated. The secondary outcome was death within 30 days of commencing daptomycin. RESULTS: A total of 233 patients were included in this analysis. Among these patients, 53 received concomitant statin therapy. Most baseline clinical characteristics were similar between statin recipients and non-recipients. Five (2.1%) patients experienced a CPK elevation; 3/53 (5.7%) were statin recipients and 2/180 (1.1%) received daptomycin alone (p = 0.08). All patients with CPK elevations had normal baseline CPK values. No effect modification was observed by use of other concomitant medications known to increase CPK values. Death was observed more frequently among statin non-recipients (17.2%) than recipients (9.4%). CONCLUSIONS: Among patients receiving daptomycin, no significant difference was observed in frequency of CPK elevation between statin recipients and non-recipients. SN - 2193-8229 UR - https://www.unboundmedicine.com/medline/citation/25245515/Effect_of_Concomitant_3_Hydroxy_3_Methyl_Glutaryl_CoA_Reductase_Inhibitor_Therapy_on_Creatine_Phosphokinase_Levels_and_Mortality_Among_Patients_Receiving_Daptomycin:_Retrospective_Cohort_Study_ L2 - https://dx.doi.org/10.1007/s40121-014-0041-y DB - PRIME DP - Unbound Medicine ER -
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