Association Between Statin Therapy and Tendon Rupture: A Case-Control Study

Abstract

Although case reports of a possible association between statin therapy and tendon rupture have been published, no analytical studies exploring this relationship have been reported. We conducted a case-control study using the electronic medical records at Michigan State University from 2002 to 2007 to assess whether statin use is a risk factor for tendon rupture. We compared exposure to statins in 93 cases of tendon rupture with similar exposure in 279 sex- and age-matched controls. Exposure to statins was defined as documentation in the electronic medical record of statin use in the 12 months preceding tendon rupture. For controls, the exposure period was defined as 1 year preceding the last office visit. We used a multivariate logistic regression model, controlling for diabetes, renal disease, rheumatologic disease, and steroid use, to calculate the adjusted odds ratios (ORs). There was no significant difference between cases and controls in the rates of statin use, with either univariate [OR = 1.0, 95% confidence interval (CI) 0.54-1.84] or multivariate analyses (OR = 1.10, 95% CI 0.57-2.13). Based on predetermined subgroup analyses, statin exposure was found to be a significant risk factor for tendon rupture in women (adjusted OR = 3.76, 95% CI 1.11-12.75) but not in men (adjusted OR = 0.66, 95% CI 0.29-1.51). In conclusion, we found no overall association between statin use and tendon rupture, but subgroup analysis suggested that women with tendon rupture were more likely to be on statins.

Shoulder Symptoms and Function in Geriatric Patients

“…10,11 The extent of this risk and the influence of gender is not clear. 12 Many of these risk factors for shoulder problems were present in a significant proportion of the study group, and we observed a high rate of shoulder pain despite the predominantly male gender of the subjects. The sample size was likely too small to detect statistically significant relationships between shoulder pain and some of these risk factors, despite the high prevalence of statin use (58%), and diabetes (50%).…”

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

“…Results between studies, however, were mixed with two finding no significant association between diabetes and tendinopathy whereas three identified a positive association. Three of these studies reviewed large medical databases15 48 50 and two sampled cohorts of working populations47 57 but subgrouping in this way did not correspond to studies that reported significant associations.…”

Simvastatin and atorvastatin reduce the mechanical properties of tendon constructs in vitro and introduce catabolic changes in the gene expression pattern

“…Rosuvastatin and atorvastatin have been more frequently linked to side effects than other statins [2, 7, 8], while simvastatin gives rise to mixed outcomes [6, 7, 9]. Two retrospective studies indicate that simvastatin might have a protective role against tendinopathy, especially in patients suffering from severe hyperlipidemia [6, 7, 9] while another study indicates that simvastatin treatment is linked to tendon complications [8]. …”