Statin-related myopathies

Practical Neurology
David Hilton-Jones

Abstract

Statins are the Marmite ('You either love it or hate it!') of the drug world, both in terms of therapeutic benefit and risk of side effects. Proponents think that they are potential life-savers, opponents that their main benefit is lining the pockets of pharma. Some consider side effects to be a major issue, outweighing any therapeutic benefit, others that they are rare and essentially innocuous. Statin-induced myalgia is relatively common but often mild and for most people does not limit treatment. In others, reducing the dose or changing the preparation may help. In all, withdrawal of the statin leads to resolution. Statin-induced rhabdomyolysis, most often precipitated by drug-drug interaction, affects only a tiny proportion of statin users, but because of the widespread prescribing of statins is an important clinical problem. Statin-induced immune-mediated necrotising myopathy represents a novel disease mechanism and clinically mimics forms of myositis. Resolution often requires immunosuppressant drug treatment, as well as statin withdrawal.

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Citations

Apr 3, 2020·Expert Opinion on Drug Safety·Dragana NikolicManfredi Rizzo
Jun 7, 2020·Practical Neurology·Jon Walters, Atik Baborie
Apr 3, 2019·The Journal of Manual & Manipulative Therapy·Gary KearnsJacqueline Doidge
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Mar 19, 2019·Muscle & Nerve·Shannon M Laboy, Michael T Pulley
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Jan 12, 2019·The American Journal of Emergency Medicine·Brit LongMichael Gottlieb
Mar 26, 2021·Clinical Medicine : Journal of the Royal College of Physicians of London·Katie Best, Achillefs Spyropoulos
Apr 4, 2021·International Journal of Molecular Sciences·Giuseppe ManninoCarla Gentile

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