Statin myopathy: a lipid clinic experience on the tolerability of statin rechallenge

Cardiovascular Therapeutics, 05/02/2012

Statin rechallenge is a real treatment option in patients with statin myopathy. Detailed history and examination is required to exclude muscle diseases unrelated to statin usage. In patients developing statin myopathy on simvastatin, authors did not find any statistical difference between subsequent tolerability rates to rosuvastatin, pravastatin, and fluvastatin.

Results

  • Patients with statin myopathy constitute 10.2% of the Lipid Clinic workload.
  • They are predominantly female (62.0%), Caucasian (63.9%), with a mean age of 58.3 years and mean body mass index (BMI) of 29.3 kg/m2.
  • The serum CK and erythrocyte sedimentation rate (ESR) were statistically higher compared to patients with statin intolerances with no muscular component or CK elevations.
  • Secondary causes of statin myopathy were implicated in 2.7% of cases.
  • Following statin myopathy to simvastatin authors found no statistical difference between the tolerability rates between atorvastatin, rosuvastatin, pravastatin, and fluvastatin.
  • Fibrates, cholestyramine, and ezetimibe were statistically better tolerated in these patients.

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