Rosuvastatin-related rhabdomyolysis causing severe proximal paraparesis and acute kidney injury

Hussain, Kosar; Xavier, Anil

doi:10.1136/bcr-2019-229244

Cited by 6 publications

(5 citation statements)

References 19 publications

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“…Second, since both drugs were not commenced concomitantly, one may consider that rhabdomyolysis was simply a statin-associated side effect and not a drug-drug interaction. Certainly, our patient received the maximum dose of rosuvastatin that is contraindicated in patients with moderate renal impairment [17]. Of note, the patient had no previous history of statin-associated muscle symptoms despite the fact that he was receiving atorvastatin for a long period.…”

Section: Discussionmentioning

confidence: 90%

Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt

Sabanis¹,

Paschou²,

Drylli

et al. 2021

CEN Case Rep

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Statins and colchicine co-administration consists of a potentially catastrophic drug-drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined myotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals regarding LDL levels with minimal myopathy risk. Therefore, once colchicine's use is commenced, a hydrophilic statin selection, such as rosuvastatin, seems favorable regarding the risk of myotoxicity. Herein, we aim to describe a patient with chronic kidney disease stage III and nephrotic syndrome that developed acute rhabdomyolysis soon after the administration of rosuvastatin while receiving colchicine. To the best of our knowledge, this is the first report of the combined effect of rosuvastatin and colchicine in the setting of chronic kidney disease leading to myotoxicity.

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Section: Discussionmentioning

confidence: 90%

Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt

Sabanis¹,

Paschou²,

Drylli

et al. 2021

CEN Case Rep

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“…Ten cases that reported rhabdomyolysis and acute kidney injury (AKI) as a result of statin use were identified. An overview of the clinical characteristics of these patients is presented in Table 3 [2,[9][10][11][12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis-induced acute kidney injury requiring hemodialysis in a patient on long-term, moderate-intensity rosuvastatin: a case report and literature review

Lee,

Kim,

Shin

et al. 2024

Med Biol Sci Eng

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Statins are widely used to prevent cardiovascular diseases. However, rhabdomyolysis is a wellknown adverse effect of statin use. The present report highlights a case of rhabdomyolysis-induced acute kidney injury (AKI) in a patient receiving long-term moderate-intensity rosuvastatin. Muscle weakness occurred 3 years after rosuvastatin administration. Myopathy and acute kidney injury resolved completely after withdrawal. To our knowledge, there have been no previously reported cases of moderate-intensity rosuvastatin-induced rhabdomyolysis-induced severe AKI requiring renal replacement therapy. This case report shows that moderate-intensity rosuvastatin therapy is also associated with risk of severe rhabdomyolysis.

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“…[30][31][32] More recent safety data on rosuvastatin are mostly from case reports. 8,9,33,34 a P for heterogeneity in IRD across eGFR subgroups was estimated using fixed effects meta-analysis and P for heterogeneity in HR was estimated using stratified Cox models with interaction term between rosuvastatin use and eGFR category. a P for heterogeneity in IRD across eGFR subgroups was estimated using fixed-effects meta-analysis and P for heterogeneity in HR was estimated using stratified Cox models with interaction term between rosuvastatin use and eGFR category.…”

Section: Discussionmentioning

confidence: 99%

“…Other observational studies reporting no increased risk of adverse events with rosuvastatin use (versus other statin use) were limited by small number of adverse events, incomplete adjustment for confounding, or lack of proteinuria and hematuria outcomes 30 – 32 . More recent safety data on rosuvastatin are mostly from case reports 8 , 9 , 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Association of Rosuvastatin Use with Risk of Hematuria and Proteinuria

Shin

Fine

Sang

et al. 2022

JASN

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BackgroundDespite reports of hematuria and proteinuria with rosuvastatin use at the time of its approval by the US Food and Drug Association (FDA), little postmarketing surveillance exists to assess real-world risk. Current labeling suggests dose reduction (maximum daily dose of 10 mg) for patients with severe CKD.MethodsUsing deidentified electronic health record data, we analyzed 152,101 and 795,799 new users of rosuvastatin and atorvastatin, respectively, from 2011 to 2019. We estimated inverse probability of treatment–weighted hazard ratios (HRs) of hematuria, proteinuria, and kidney failure with replacement therapy (KFRT) associated with rosuvastatin. We reported the initial rosuvastatin dose across eGFR categories and evaluated for a dose effect on hematuria and proteinuria.ResultsOverall, we identified 2.9% of patients with hematuria and 1.0% with proteinuria during a median follow-up of 3.1 years. Compared with atorvastatin, rosuvastatin was associated with increased risk of hematuria (HR, 1.08; 95% confidence interval [95% CI], 1.04 to 1.11), proteinuria (HR, 1.17; 95% CI, 1.10 to 1.25), and KFRT (HR, 1.15; 95% CI, 1.02 to 1.30). A substantial share (44%) of patients with eGFR <30 ml/min per 1.73 m2 was prescribed high-dose rosuvastatin (20 or 40 mg daily). Risk was higher with higher rosuvastatin dose.ConclusionsCompared with atorvastatin, rosuvastatin was associated with increased risk of hematuria, proteinuria, and KFRT. Among patients with eGFR <30 ml/min per 1.73 m2, 44% were prescribed a rosuvastatin daily dose exceeding the FDA’s recommended 10 mg daily dose. Our findings suggest the need for greater care in prescribing and monitoring rosuvastatin, particularly in patients who receive high doses or who have severe CKD.

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Rosuvastatin-related rhabdomyolysis causing severe proximal paraparesis and acute kidney injury

Cited by 6 publications

References 19 publications

Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt

Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt

Rhabdomyolysis-induced acute kidney injury requiring hemodialysis in a patient on long-term, moderate-intensity rosuvastatin: a case report and literature review

Association of Rosuvastatin Use with Risk of Hematuria and Proteinuria

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