Factors associated with statin-related adverse muscular events in adult dyslipidemic outpatients

Abstract

Statins are the most prescribed lowering-cholesterol drugs. They are well tolerated, however, some patients present muscular adverse symptoms. Clinical and laboratory data from 120 dyslipidemic patients prescribed with statins were obtained from January to December/2013 at a University Hospital in Sao Paulo city, Brazil, to study factors associated with statin-related adverse muscular events (AME). Pharmacotherapy and statin-related AME data (serum CK elevation and any degree of myopathy, myalgia, myositis or rhabdomyolysis) of the dyslipidemic patients were recorded. The study was approved by local Ethics Committees. Simvastatin (70%) and atorvastatin (25%) were the most prescribed statins. AME related to statin treatment were found in 17% of the patients. Mean age and use of simvastatin were lower in AME group than non-AME group (p<0.05). Simvastatin users were less likely to develop AME than atorvastatin users (OR=0.21; 95%CI=0.07-0.57; p<0.01). The use of P-glycoprotein (ABCB1) efflux pump inhibitors was associated with high risk for AME (OR=5.26; p<0.01). Serum liver enzymes were increased up to three-fold in 2.5% of the statin-treated patients. The results are suggestive that the type of statin prescribed and the concomitant use of ABCB1 inhibitors increase the susceptibility to adverse muscular events during statin therapy in dyslipidemic outpatients.

Mikania micrantha Extract Inhibits HMG-CoA Reductase and ACAT2 and Ameliorates Hypercholesterolemia and Lipid Peroxidation in High Cholesterol-Fed Rats

“…It is noteworthy that prominent adverse effects associated with the administration of the statin group are asymptomatic increases in liver transaminases as well as myopathy [ 31 ]. According to Castro et al [ 32 ], the frequency of liver enzymes increased in a small proportion of those taking statins (2.5%). On the contrary, rats which were supplemented with EAMMS showed no differences in AST and ALT levels as compared to those in the NC group.…”

Intersection between Obesity, Dietary Selenium, and Statin Therapy in Brazil

“…In Brazil, the percentage of patients that are intolerant to statins varies between 5 and 10%. Adverse muscular events related to statin treatment were found in 17% of patients treated in the University Hospital in Sao Paulo city, Brazil [102].…”

Statin associated adverse reactions in Latin America: a scoping review

“…The studies included were from Argentina (n=3), [33][34][35] Brazil (n=4), [36][37][38][39] Colombia (n=4), [40][41][42][43] and Mexico (n=2). 44 45 A total population of 4680 subjects were evaluated across the studies.…”

“…37 38 41-43 In addition, a study evaluated the efficacy and safety of rosuvastatin in HIV-positive patients. 35 The funding sources of the studies were as follows: industry (n=4), 33 41 42 44 nonindustry (n=4), [36][37][38][39] none (n=1) 45 and not described (n=4). 34…”

“…36 Ferreira Castro et al evaluated patients on simvastatin or atorvastatin and found that 17% presented muscle-related ADRs and 2.5% presented a threefold increase in LFTs. 38 Ruiz et al assessed the state of dyslipidaemia in Colombia and mentioned atorvastatin, rosuvastatin, lovastatin, and simvastatin as the most used statins. 41 ADRs frequency ranged from 4.0% to 5.2%, and statin intolerance was reported in 2.6%.…”