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A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect on Creatine Phosphokinase.
Open Forum Infect Dis. 2019 Nov; 6(11):ofz444.OF

Abstract

Objective

Daptomycin has been associated with increased creatine phosphokinase (CPK) due to muscle injury leading to myalgias and muscle weakness. Statins have been proven to cause the same effects and it is recommended to discontinue the use of statins while on daptomycin. Evidence regarding this drug interaction is mixed. This study evaluated the risk of CPK elevation in concomitant use of daptomycin and statins compared to daptomycin alone.

Method

This is a multisite retrospective case-control study of patients who received daptomycin therapy with monitoring of CPK. Rates of CPK elevations were compared in patients receiving daptomycin with a statin versus daptomycin alone. To estimate the association between CPK elevation and daptomycin therapy controlling for other risk factors, logistic regression was used to analyze data. Statistical significance was determined at ɑ of 0.05.

Results

A total of 3658 patients were included in the study, with 2787 on daptomycin therapy alone and 871 with concurrent statin use. The incidence of CPK elevation was 90 events (3.2%) in the daptomycin group and 26 events (3.0%) in the concurrent statin group. Patients who received daptomycin therapy in addition to statins had no statistically significant difference from patients on daptomycin alone (hazard ratio, 1.05; P = .85; 95% confidence interval, 0.61-1.84). After adjusting for potential risk factors, the hazards ratio remained almost the same.

Conclusions

Concomitant use of daptomycin and statin did not show an increase risk of CPK elevation. Clinicians may consider concomitant use of daptomycin and statin therapy with weekly CPK monitoring.

Authors+Show Affiliations

Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA.Department of Pharmacy, Barnes-Jewish Hospital, St. Louis, Missouri, USA.CORE Research Office, Ohio University Heritage College of Osteopathic Medicine, Dublin, Ohio, USA.Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31723571

Citation

Lehman, Bethany, et al. "A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect On Creatine Phosphokinase." Open Forum Infectious Diseases, vol. 6, no. 11, 2019, pp. ofz444.
Lehman B, Neuner EA, Heh V, et al. A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect on Creatine Phosphokinase. Open forum infectious diseases. 2019;6(11):ofz444.
Lehman, B., Neuner, E. A., Heh, V., & Isada, C. (2019). A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect on Creatine Phosphokinase. Open Forum Infectious Diseases, 6(11), ofz444. https://doi.org/10.1093/ofid/ofz444
Lehman B, et al. A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect On Creatine Phosphokinase. Open forum infectious diseases. 2019;6(11):ofz444. PubMed PMID: 31723571.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Retrospective Multisite Case-Control Series of Concomitant Use of Daptomycin and Statins and the Effect on Creatine Phosphokinase. AU - Lehman,Bethany, AU - Neuner,Elizabeth A, AU - Heh,Victor, AU - Isada,Carlos, Y1 - 2019/11/07/ PY - 2019/04/10/received PY - 2019/10/28/accepted PY - 2019/11/15/entrez PY - 2019/11/15/pubmed PY - 2019/11/15/medline KW - CPK elevation KW - daptomycin KW - myalgia KW - statin SP - ofz444 EP - ofz444 JF - Open forum infectious diseases VL - 6 IS - 11 N2 - Objective: Daptomycin has been associated with increased creatine phosphokinase (CPK) due to muscle injury leading to myalgias and muscle weakness. Statins have been proven to cause the same effects and it is recommended to discontinue the use of statins while on daptomycin. Evidence regarding this drug interaction is mixed. This study evaluated the risk of CPK elevation in concomitant use of daptomycin and statins compared to daptomycin alone. Method: This is a multisite retrospective case-control study of patients who received daptomycin therapy with monitoring of CPK. Rates of CPK elevations were compared in patients receiving daptomycin with a statin versus daptomycin alone. To estimate the association between CPK elevation and daptomycin therapy controlling for other risk factors, logistic regression was used to analyze data. Statistical significance was determined at ɑ of 0.05. Results: A total of 3658 patients were included in the study, with 2787 on daptomycin therapy alone and 871 with concurrent statin use. The incidence of CPK elevation was 90 events (3.2%) in the daptomycin group and 26 events (3.0%) in the concurrent statin group. Patients who received daptomycin therapy in addition to statins had no statistically significant difference from patients on daptomycin alone (hazard ratio, 1.05; P = .85; 95% confidence interval, 0.61-1.84). After adjusting for potential risk factors, the hazards ratio remained almost the same. Conclusions: Concomitant use of daptomycin and statin did not show an increase risk of CPK elevation. Clinicians may consider concomitant use of daptomycin and statin therapy with weekly CPK monitoring. SN - 2328-8957 UR - https://www.unboundmedicine.com/medline/citation/31723571/A_Retrospective_Multisite_Case_Control_Series_of_Concomitant_Use_of_Daptomycin_and_Statins_and_the_Effect_on_Creatine_Phosphokinase_ L2 - https://academic.oup.com/ofid/article-lookup/doi/10.1093/ofid/ofz444 DB - PRIME DP - Unbound Medicine ER -
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