Statin induced myopathy risk factors: Difference between revisions

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Latest revision as of 20:49, 1 December 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby

Overview

Several risk factors predispose to statin induced myopathy. Some of the intrinsic risk factors are advanced age, genetic predisposition, diabetes, hypertension, hypothyroidism and renal diseases. Other extrinsic factors play a role in statin induced myopathy, including alcohol consumption, vitamin D deficiency, excessive exercise, trauma or concomitant use of other drugs like fibrates mainly gemfibrosil, protease inhibitors and macrolide antibiotics.^[1]^[2]^[3]

Risk Factors

Intrinsic Risk Factors

Advanced age (> 80 years)^[1]
Carnitine palmityl transferase II deficiency
Diabetes mellitus
Genetic polymorphisms of CYP450 isoenzymes (single nucleotide polymorphism of the gene SLCO1B1)^[2]
Hepatic disease
Hypertension
Hypothyroidism
McArdle disease
Metabolic muscle disease
Myadenylate deaminase deficiency^[3]
Renal disease
Small body mass index^[1]

Extrinsic Risk Factors

Alcohol consumption
Amiodarone
Azole antifungals
Cyclosporins
Fibrates particularly gemfibrozil (cerivastatin in combination with gemfibrosil)^[4]
Grapefruit juice
Heavy exercise
High dose of statins^[2]
Macrolide antibiotics
Major trauma^[4]
Polypharmacy^[2]
Protease inhibitors^[3]
Surgery^[4]
Warfarin

References

↑ ^1.0 ^1.1 ^1.2 Venero CV, Thompson PD (2009). "Managing statin myopathy". Endocrinol Metab Clin North Am. 38 (1): 121–36. doi:10.1016/j.ecl.2008.11.002. PMID 19217515.
↑ ^2.0 ^2.1 ^2.2 ^2.3 Harper CR, Jacobson TA (2010). "Evidence-based management of statin myopathy". Curr Atheroscler Rep. 12 (5): 322–30. doi:10.1007/s11883-010-0120-9. PMID 20628837.
↑ ^3.0 ^3.1 ^3.2 Toth PP, Harper CR, Jacobson TA: Clinical characterization and molecular mechanisms of statin myopathy. Expert Rev Cardiovasc Ther 2008, 6:955–969
↑ ^4.0 ^4.1 ^4.2 Hamilton-Craig I (2001). "Statin-associated myopathy". Med J Aust. 175 (9): 486–9. PMID 11758079.

[pmid19217515-1] 1.0 ^1.1 ^1.2 Venero CV, Thompson PD (2009). "Managing statin myopathy". Endocrinol Metab Clin North Am. 38 (1): 121–36. doi:10.1016/j.ecl.2008.11.002. PMID 19217515.

[pmid20628837-2] 2.0 ^2.1 ^2.2 ^2.3 Harper CR, Jacobson TA (2010). "Evidence-based management of statin myopathy". Curr Atheroscler Rep. 12 (5): 322–30. doi:10.1007/s11883-010-0120-9. PMID 20628837.

[toth-3] 3.0 ^3.1 ^3.2 Toth PP, Harper CR, Jacobson TA: Clinical characterization and molecular mechanisms of statin myopathy. Expert Rev Cardiovasc Ther 2008, 6:955–969

[pmid11758079-4] 4.0 ^4.1 ^4.2 Hamilton-Craig I (2001). "Statin-associated myopathy". Med J Aust. 175 (9): 486–9. PMID 11758079.

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[2]

[3]

[4]

@@ Line 5: / Line 5: @@
 ==Overview==
+Several risk factors predispose to [[statin induced myopathy]]. Some of the intrinsic risk factors are advanced age, genetic predisposition, [[diabetes]], [[hypertension]], [[hypothyroidism]] and renal diseases. Other extrinsic factors play a role in [[statin induced myopathy]], including [[alcohol]] consumption, [[vitamin D deficiency]], excessive exercise, trauma or concomitant use of other drugs like [[fibrates]] mainly [[gemfibrosil]], [[protease inhibitors]] and [[macrolide|macrolide antibiotics]].<ref name="pmid19217515">{{cite journal| author=Venero CV, Thompson PD| title=Managing statin myopathy. | journal=Endocrinol Metab Clin North Am | year= 2009 | volume= 38 | issue= 1 | pages= 121-36 | pmid=19217515 | doi=10.1016/j.ecl.2008.11.002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19217515  }} </ref><ref name="pmid20628837">{{cite journal| author=Harper CR, Jacobson TA| title=Evidence-based management of statin myopathy. | journal=Curr Atheroscler Rep | year= 2010 | volume= 12 | issue= 5 | pages= 322-30 | pmid=20628837 | doi=10.1007/s11883-010-0120-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20628837  }} </ref><ref name="toth">Toth PP, Harper CR, Jacobson TA: Clinical characterization and molecular mechanisms of statin myopathy. Expert Rev Cardiovasc Ther 2008, 6:955–969</ref>
 ==Risk Factors==
@@ Line 26: / Line 27: @@
 *[[Antigunfals|Azole antifungals]]
 *[[Cyclosporins]]
-*[[Fibrates]] particularly [[gemfibrozil]] (Cerivastatin in combination with [[gemfibrosil]])<ref name="pmid11758079">{{cite journal| author=Hamilton-Craig I| title=Statin-associated myopathy. | journal=Med J Aust | year= 2001 | volume= 175 | issue= 9| pages= 486-9 | pmid=11758079 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11758079  }} </ref>
+*[[Fibrates]] particularly [[gemfibrozil]] (cerivastatin in combination with [[gemfibrosil]])<ref name="pmid11758079">{{cite journal| author=Hamilton-Craig I| title=Statin-associated myopathy. | journal=Med J Aust | year= 2001 | volume= 175 | issue= 9| pages= 486-9 | pmid=11758079 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11758079  }} </ref>
-*Grapefruit juice (> 1quart/day)
+*Grapefruit juice
 *Heavy [[exercise]]
-*High dose of [[statin]]<ref name="pmid20628837">{{cite journal| author=Harper CR, Jacobson TA| title=Evidence-based management of statin myopathy. | journal=Curr Atheroscler Rep | year= 2010 | volume= 12 | issue= 5 | pages= 322-30 | pmid=20628837 | doi=10.1007/s11883-010-0120-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20628837  }} </ref>
+*High dose of [[statins]]<ref name="pmid20628837">{{cite journal| author=Harper CR, Jacobson TA| title=Evidence-based management of statin myopathy. | journal=Curr Atheroscler Rep | year= 2010 | volume= 12 | issue= 5 | pages= 322-30 | pmid=20628837 | doi=10.1007/s11883-010-0120-9 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20628837  }} </ref>
 *[[Macrolide]] [[antibiotics]]
 *Major trauma<ref name="pmid11758079">{{cite journal| author=Hamilton-Craig I| title=Statin-associated myopathy. | journal=Med J Aust | year= 2001 | volume= 175 | issue= 9 | pages= 486-9 | pmid=11758079 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11758079  }} </ref>