Chronic Muscle Diseases Associated With Statin Exposure

NEW YORK (Reuters Health) May 16 - Statin use is twice as high in patients with chronic muscle diseases as in unaffected controls, according to a report in the May issue of the Annals of the Rheumatic Diseases.

Some clinical reports have suggested that statins can trigger chronic muscle diseases, including dermatomyositis and polymyositis, the authors explain, but no previous study has investigated exposure to statins in patients who develop a chronic muscle disease.

Dr. L. Sailler from the University of Toulouse, France and associates evaluated the association between chronic muscle diseases occurring in 37 patients after the age of 50 and their prior exposure to statins and fibrates.

Patients with chronic muscle diseases were 2.73 times more likely than controls to have a history of statin use and 4.36 times more likely than controls to use statins regularly, the authors report.

Twelve of 15 statin patients and 6 of 22 non-statin patients were also exposed to at least one other drug with potential myotoxicity or with possible interference with statin metabolism, the researchers note, and there was a positive interaction between statins and proton pump inhibitors (PPIs) and the risk of chronic muscle disease.

The relationship of statins to chronic muscle disease persisted when the analysis was limited to patients with dermatomyositis or polymyositis or patients with genetic myopathy.

There was no difference between patients and controls in their exposure to fibrates.

"Clinicians should be aware of the possibility of statin- and perhaps PPI-induced inflammatory myopathies even in patients taking the drugs for a long time, withdraw the statin in all patients with dermatomyositis/polymyositis, and systematically reconsider the value of statin prescription," the authors conclude.

Ann Rheum Dis 2008;67:614-619.

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