Muscle rupture associated with statin use

Abstract

Keywords adverse drug reaction, muscle rupture, statins AIMStatins are used in the treatment of hyperlipidaemia. They are among the most commonly prescribed drugs worldwide. Statins have been linked to musculoskeletal adverse drug reactions. However muscle rupture has not been discussed as an adverse drug reaction to statins so far. The aim of this article is to give an overview of cases of muscle rupture associated with the use of statins. METHODWe analyzed the cases of muscle rupture associated with the use of statins that were collected by the Netherlands Pharmacovigilance Centre Lareb complemented with the review of cases from the EudraVigilance database. RESULTSFifteen cases of muscle rupture associated with statin use have been identified in the database of the Netherlands Pharmacovigilance Centre. Overall, there was a plausible temporal association of events in most cases. In addition, the EudraVigilance database contained 165 reports of muscle rupture reported in patients using statins. Muscle rupture was disproportionally associated with statin use in both databases. The reporting odds ratio was 23.4 (95% CI 11.9, 46.0) and 14.6 (95% CI 12.3, 17.2), respectively. CONCLUSIONData from spontaneous reporting systems suggest that use of statins is associated with muscle rupture. Physicians and patients should be aware that this can occur. WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Statins are among the most commonly prescribed drugs worldwide and are usually well tolerated.• However 10-15% of statin users develop statin-related musculoskeletal side effects, but muscle rupture has not been discussed as an adverse drug reaction to statins. WHAT THIS STUDY ADDS• Data from spontaneous reporting systems suggest that use of statins is associated with muscle rupture.• Physicians and patients should be aware that this can occur.

A short-term statin treatment changes the contractile properties of fast-twitch skeletal muscles

“…A more compliant membrane/extracellular matrix in statin-treated mice would lower dP/dT. Accordingly, statins cause a deterioration of the biomechanical properties of the Achilles tendon [48] and may be a risk factor for muscle and tendon ruptures and tendinopathies [49, 50]. Statins have thus pleiotropic properties, but the exact mechanism by which they decrease dP/dT requires further investigation.…”

ISMP Adverse Drug Reactions: Levofloxacin-Induced Neuroexcitation and Hallucinations; Statin-Induced Muscle Rupture; Mefloquine-Induced Rhabdomyolysis; Methimazole-Induced Cholestatic Hepatitis; Decitabine-Induced Hand and Foot Syndrome

“…Ekhart et al 2 conducted a study to analyze the occurrence of muscle rupture in 2 European pharmacovigilance databases. The first database is maintained by the Netherlands Pharmacovigilance Center, which has collected reports since 1990.…”

The association of GATM polymorphism with statin-induced myopathy: a systematic review and meta-analysis

“…Statin-induced myopathy (SIM) is the most frequently reported adverse effect of statins and is the commonest cause for discontinuation of statin therapy [ 1 ]. Symptoms of SIM can vary from mild myalgia to rare but life-threatening rhabdomyolysis [ 2 ]. The high prevalence of statin use made the absolute number of SIM became more substantial.…”