Characterization of Statin-Associated Myopathy Case Reports in Thailand Using the Health Product Vigilance Center Database

Abstract

Characteristics of muscle-related adverse events with statins in the Thai population showed some similarities and differences compared with Western countries. Such similarities included advanced age, female sex, certain co-morbidities and drug interactions. While the majority of interacting drugs are well known, a big proportion of cases of statin-colchicine interaction attributed to long-term use of colchicine in Thailand was noted and should be further investigated. Based on these results, an attempt to avoid dangerous and well-known drug interactions among statin users should be implemented nationwide.

Evaluating the safety of Liptruzet (ezetimibe and atorvastatin): what are the potential benefits beyond low-density lipoprotein cholesterol-lowering effect?

“…Fifty-two patients (1.6% of all study participants) interrupted atorvastatin therapy due to drug-related adverse effects, which comprised mainly of increased liver transaminases (0.4%) and myalgia (0.5%), whereas no cases of rhabdomyolysis were reported [54].The frequency of statin-associated myopathy, which represents a broad spectrum of disorders from insignificant myalgia to fatal rhabdomyolysis, ranges from 1 --5% in clinical trials to 15 --20% in everyday clinical practice [55]. Similar observations were also noted in Thai patients [56].…”

Gout: An old disease in new perspective – A review

“…The French regulatory agency contraindicates co-prescription of macrolide antibiotics and colchicine, even though azythromycin has been found to have no pharmacokinetic interaction with colchicine. Muscle toxicity, including rhabdomyolysis has been reported with the concomitant use of colchicine and statins, especially in renal failure patients [116]. Nerve and muscle toxicity can be observed in long term low dose colchicine users who have kidney transplant or chronic kidney disease CKD, usually with 30 mL/min of eGFR or less [117].…”

Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options

“…Therefore, the colchicine dose should be reduced in CKD patients. Co-prescription of statins [114] or drugs interacting with colchicine by inhibiting cytochrome P450 or 3A4 / P-glycoprotein [115] should be avoided in patients with renal failure.…”