Prevalence of Myopathy in Subjects on Statin Therapy Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan

Yazan Khlief ,Dana Hyassat ,Mohammed Liswi ,Hashem Jaddou ,Kamel Ajlouni

doi:10.4172/2161-1017.1000204

Yazan Khlief , Dana Hyassat + Show 3 more

Open Access

https://doi.org/10.4172/2161-1017.1000204

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Abstract

Objective: This study aims to find the prevalence and risk factors of myopathy in subjects on statin therapy. Methods: Cross sectional study was conducted on 1046 subjects on statin therapy for dyslipidemia who were attending the National center for Diabetes, Endocrinology and Genetics [NCDEG] in Jordan between Sep. and Dec. 2012. Questionnaire was used to collect demographic data, medical history and muscular symptoms. Results: The prevalence of muscular symptoms among subjects taking statin was 27.9%, when subjects referred their muscular symptoms to statin the prevalence drop to 16.4%. Bivariate and multivariate analyses showed significant association between muscular symptoms and hypothyroidism, taking medication or substances that are known to interact with statin treatment [Fibrates, Verapamil, Amiodarone, Warfarin, Digoxin or Grapefruit juice [>1 quart/day]], and allopurinol therapy. Conclusions: Statin use is significantly associated with high prevalence of musculoskeletal pain [27.9%]. Although many clinicians perceive myalgia as a minor adverse effect, its clinical significance should not be underestimated, as myalgia could be a major obstacle to treatment adherence.

Highlights

High plasma levels of total cholesterol and Low-Density Lipoprotein [LDL] are well-established risk factors for coronary heart disease [13]
Statin induced myopathy was significantly associated with hypothyroidism [p value .034], taking medication or substances that are known to interact with statin treatment [Fibrates, Verapamil, Amiodarone, Warfarin, Digoxin or Grapefruit juice [>1 quart/day]] [p value .050] and Allopurinol [p value .047]
Our study showed that concomitant use of statins with Allopurinol and other medication increases the risk of developing statin- induced myopathy by 2.18 for Allopurinol and 1.46 for other medication, respectively

Summary

Introduction

High plasma levels of total cholesterol and Low-Density Lipoprotein [LDL] are well-established risk factors for coronary heart disease [13]. Statins significantly lower cholesterol levels and have been shown to significantly reduce morbidity and mortality associated with heart disease [4,5,6,7,8]. Because statins are potentially lifesaving, their tolerability and adherence is a major concern. Statins are well tolerated with minimal serious side effects [9]. The incidence of myalgia [generally defined as muscle symptoms without significant creatine kinase elevation] approximates 1-7% of statin-users in randomized clinical trials, with rates similar to placebo groups [12,13,14]. The frequency of muscle complaints reported in usual care settings appears to be higher than in clinical trials with a frequency of 9% to 22% in outpatient settings [15,16,17,18]

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