Statin associated muscle symptoms: An update and review

Dicken, Weston; Mehta, Anurag; Karagiannis, Angelos; Jain, Vardhmaan; Vavuranakis, Michael-Andrew; Sperling, Laurence; Cassimatis, Dimitri C.

doi:10.1016/j.pcad.2022.11.010

Cited by 14 publications

(4 citation statements)

References 51 publications

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“…Statin use has been reported to induce myopathy ( Lazris and Roth, 2019 ; Ward et al, 2019 ; Dicken et al, 2022 ), so it may increase the risk of falling problems. No randomized controlled trials have been conducted to examine whether statin use increases the risk of falling problems.…”

Section: Discussionmentioning

confidence: 99%

Statin use and fall risk in adults: a cross-sectional survey and mendelian randomization analysis

Zheng,

Fang,

Wang

et al. 2024

Front. Pharmacol.

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Background and ObjectiveThe issue of falls poses a significant threat to the health of the elderly population. Although statins can cause myopathy, which implies that they may cause balance problems and increase the risk of falling, this has not been tested. Our objective was to assess whether the use of statins is linked to a higher risk of falls.MethodsA cross-sectional survey study and Mendelian randomization (MR) study were conducted to examine whether the use of statins was associated with an increased risk of falling and balance problems. The cross-sectional study included 2,656 participants from the US population (NHANES) who reported information on balance and falling problems in the past year and their use of statins. Univariate and multivariate logistic regression models were used to investigate the association between statin use and the likelihood of falling or experiencing balance problems. The MR study identified five Single Nucleotide Polymorphisms (SNPs) that predict statin use across five ancestry groups: Admixed African or African, East Asian, European, Hispanic, and South Asian. Additionally, SNPs predicting the risk of falls were acquired from the UK Biobank population. A two-sample MR analysis was performed to examine whether genetically predicted statin use increased the risk of falls.ResultsThe use of statins was found to be associated with an increased likelihood of balance and falling problems (balance problem, OR 1.25, 95%CI 1.02 to 1.55; falling problem, OR 1.27, 95%CI 1.03–1.27). Subgroup analysis revealed that patients under the age of 65 were more susceptible to these issues when taking statins (balance problem, OR 3.42, 95%CI 1.40 to 9.30; falling problem, OR 5.58, 95%CI 2.04–15.40). The MR analysis indicated that the use of statins, as genetically proxied, resulted in an increased risk of falling problems (OR 1.21, 95% CI 1.1–1.33).ConclusionOur study found an association between the use of statins and an increased risk of balance problems and falls in adults over 40 years old, and the MR study result suggested statin use increased risk of falls. The risk was higher in participants under 65 years old compared to those over 65 years old.

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Section: Discussionmentioning

confidence: 99%

Statin use and fall risk in adults: a cross-sectional survey and mendelian randomization analysis

Zheng,

Fang,

Wang

et al. 2024

Front. Pharmacol.

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“…Currently, there are seven statins (rosuvastatin, atorvastatin, simvastatin, pitavastatin, lovastatin, pravastatin, and fluvastatin) that are readily available and have been proven to be well tolerated 5 . Although statins are generally considered safe, their systemic exposure may be influenced by drug–drug interactions (DDI), which may increase the risk of statin-associated muscle symptoms (SAMS) 10 , 11 . These interactions are predominantly facilitated by metabolic enzymes, primarily cytochrome P450 (CYP) isoenzymes, and membrane-bound transporters, including P-glycoprotein (P-gp) and organic anion-transporting polypeptides (OATPs) 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Numerous studies have confirmed the importance of OATP1B1 in the clinical efficacy and adverse reactions of statins, with a focus on SLCO1B1 SNPs 18 , 19 , 20 . In addition, due to the presence of SAMS and SNPs, more and more research has focused on statin-related DDI mediated by OATP1B1 10 , 11 , 12 . Therefore, it is critical to recognize the contribution of OATP1B1 to statin uptake to ensure their safe administration.…”

Section: Introductionmentioning

confidence: 99%

Construction and characterization of a humanized SLCO1B1 rat model with its application in evaluating the uptake of different statins

Zhang,

Huang,

Huang

et al. 2024

Acta Pharmaceutica Sinica B

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“…The use of RYR as a dietary supplement may therefore lead to people being exposed to monacolin K at levels within the recommended therapeutic dose range of lovastatin, which is from 10 to 80 mg/day [6]. Therefore, consumption of RYR can potentially lead to muscle-related symptoms similar to the muscle-related side effects of statin-based therapies [7], which can range from mild muscle discomfort to more severe muscle pain, known as myopathy. In addition, monacolin K can have similar effects on the liver as statins [8], and in some cases, it has caused liver damage [9], despite the fact that a causal relation between any liver harm and statin therapy has never been confirmed.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Red Yeast Rice Extract Use on the Occurrence of Muscle Symptoms and Liver Dysfunction: An Update from the Adverse Event Reporting Systems and Available Meta-Analyses

Norata,

Banach

2024

Nutrients

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Red yeast rice (RYR) has a cholesterol-lowering effect due to the presence of bioactive components (monacolins, mainly monacolin K) that act by inhibiting the activity of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. The European Food Safety Authority (EFSA) assessed the use of RYR and, while pointing out several uncertainties regarding the available data, raised a warning related to the safety of RYR when used as a food supplement at a dose of monacolin as low as 3 mg/day. In their decision in June 2023, EFSA approved the use of monacolins from RYR at doses less than 3 mg/day. We therefore decided to interrogate the different adverse event reporting systems (FAERS and CAERS) and analyse the characteristics of the cases reported to be associated with RYR supplements, and we reviewed the most recent meta-analyses with a focus on the occurrence of muscle symptoms and liver dysfunction. In terms of all musculoskeletal disorders from September 2013 (when the first case related to RYR consumption was recorded) to 30 September 2023, 363,879 cases were reported in the FAERS, with the number of cases related to RYR consumption being very small and accounting for 0.008% of cases. In the same time frame, 27,032 cases of hepatobiliary disorders were reported, and the cases attributable to RYR ingestion accounted for 0.01% of all cases. A low rate of muscle symptoms and liver dysfunction attributed to RYR ingestion was also observed in the CAERS database, where only 34 cases of adverse muscle events and 10 cases of adverse liver events reported RYR as the suspect product, while 19 cases of both muscle events and 10 cases of adverse liver events reported it as a concomitant product. This profile mirrors that of meta-analyses of randomised clinical trials of RYR, in which RYR use was not associated with either liver dysfunction or muscular adverse symptoms.

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Statin associated muscle symptoms: An update and review

Cited by 14 publications

References 51 publications

Statin use and fall risk in adults: a cross-sectional survey and mendelian randomization analysis

Statin use and fall risk in adults: a cross-sectional survey and mendelian randomization analysis

Construction and characterization of a humanized SLCO1B1 rat model with its application in evaluating the uptake of different statins

The Impact of Red Yeast Rice Extract Use on the Occurrence of Muscle Symptoms and Liver Dysfunction: An Update from the Adverse Event Reporting Systems and Available Meta-Analyses

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