Abstract
Objective: To characterize the prognosis of statin myopathy. Background Statin drugs cause myalgias, fatigue, weakness, and CK elevation, which often linger after discontinuing the drugs. The prognosis has not been well studied. Design/Methods: 143 patients with a diagnosis of toxic myopathy or myopathy and hyperlipidemia were identified from our patients9 database. 69/143 with muscle symptoms and/or CK elevation developed after initiating statin therapy without other identifiable causes were chosen for further studies by chart review. Results: Mean age at presentation was 62 years (range:37-91). 49 (71.0%) patients were men. Mean duration of statin use was 29.6 months (range:0.25-122). Myalgias was reported by 63 (91.3%), fatigue by 47 (68.1%), and weakness by 42 (60.9%). 18 (26.1%) patients had detectable muscle weakness. Mean CK level at presentation was 790 IU/L (range: 33-5091), normal in 17 (24.6%), mildly elevated ( 1,000) in 16 (23.2%). 32 (46.4%) patients had NCS/EMG, with myopathy diagnosed in 4 (12.5%). 16 (23.2%) patients underwent muscle biopsies, with non-specific myopathic changes seen in 4 (25.0%). Statin was discontinued in all patients. Mean duration of follow-up was 18.2 months (range: 1-120). Muscle symptoms completely resolved in 50 (72.5%), improved in 9 (13.0%), and unchanged in 10 (14.5%). Of those with symptoms resolved, 24.0% occurred within 1 month, 62.0% within 3 months, 90.0% within 6 months, and 96.0% within 1 year. 10/52 (19.2%) patients had their CK levels return to normal. Clinical improvement was not influenced by the presence of weakness, CK elevation, or myopathic changes on EMG or muscle biopsies. Conclusions: Majority of patients with statin myopathy are men and their disease is mild. Muscle symptoms can linger but rarely beyond 1 year. NCS/EMG and muscle biopsy, which can be useful to rule out other diseases, are not helpful to determine the prognosis. Disclosure: Dr. Armour has nothing to disclose. Dr. Zhou has nothing to disclose.
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