Abstract
Objectives Statin-induced myopathy is one of the major causes of poor adherence and discontinuation of this medication. There are contrary results regarding association of vitamin D insufficiency with statin-induced myopathy. This study was done to determine the effect of the vitamin D3 analogue alfacalcidol on Rosuvastatin-induced myopathy in rats. Methodology. Animals were divided into six groups with 6 rats in each group. Groups I and II acted as controls, Group III and Group IV were administered Rosuvastatin 120 mg/kg/day and 160 mg/kg/day, Groups V and VI were administered alfacalcidol 0.1 μg/kg/day in addition to Rosuvastatin 120 mg/kg/day and 160 mg/kg/day, respectively. All drugs were administered orally for 15 days. Plasma creatine kinase (CK) levels were estimated on day 10 and day 15. Animals were sacrificed and muscles were sent for histopathological examination. Results On day 10, Groups V and VI showed a statistically significant increase in plasma CK levels as compared to the control (p < 0.001) and were significantly lower (p < 0.001) as compared to Groups III and IV, respectively. However, on day 15, plasma CK levels in Groups V and VI were comparable to those of control groups with a nonsignificant difference (p > 0.05). On comparing the histology, Groups V and VI showed a significant difference as compared to statin-only groups (Groups III and IV) as there were signs of regeneration, less splitting, and fragmentation of muscle fibres. Conclusion The present study shows that the vitamin D analogue alfacalcidol prevents statin-induced myopathy. The serum CK levels are comparable to the control group on day 15 of vitamin D administration.
Highlights
Hydroxy-methyl-glutaryl Coenzyme A (HMG CoA) reductase inhibitors or statins offer one of the most effective strategies for reducing cardiovascular diseases. ey are mainstay in management of dyslipidemia, coronary artery disease, hypertension, and stroke
Post hoc analysis did not show any significant difference between the creatine kinase (CK) levels of the two control groups
Myopathy, rhabdomyolysis, hepatotoxicity, e Scientific World Journal headache, rash, and gastrointestinal side effects are encountered in patients on statins [14]
Summary
Hydroxy-methyl-glutaryl Coenzyme A (HMG CoA) reductase inhibitors or statins offer one of the most effective strategies for reducing cardiovascular diseases. ey are mainstay in management of dyslipidemia, coronary artery disease, hypertension, and stroke. Hydroxy-methyl-glutaryl Coenzyme A (HMG CoA) reductase inhibitors or statins offer one of the most effective strategies for reducing cardiovascular diseases. E nonadherence to statins increases the risk of acute cardiovascular events. E nonadherence and discontinuation of statins is multifactorial, and one of the major reasons is statin induced muscle-related side effects which range from mild myalgia to fatal rhabdomyolysis. E effect of different statins on lipid profile is dose dependent, and Rosuvastatin, a relatively newer member of the statin family of drugs, has a superior effect in improving lipid profile as observed in Asian e Scientific World Journal population [4]. Rosuvastatin is linked with high incidence of muscle-related adverse effects in comparison to other statins [5]. Product labelling in Europe highlights this risk at high doses of statins (40 mg once a day) [6]
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