Abstract
ObjectiveTo evaluate the association between statin use and symptom severity, tender point count, fatigue, cognition, mood, and sleep issues in patients with fibromyalgia (FM).MethodsBetween May 2012 and November 2013, 668 patients with FM were surveyed. Patients were stratified into statin users and statin nonusers. Primary outcome was FM symptom severity (FIQ-R questionnaire) and tender point count. Secondary outcomes included fatigue (MFI-20), cognitive dysfunction (MASQ), anxiety (GAD-7), depression (PHQ-9), and sleep issues (SPI-II). Regression analysis assessed for differences in these clinical outcomes between statin users and statin nonusers and adjusted for age, sex, body mass index, ethnicity, tobacco use, opioid use, and neuropathic medication use.ResultsOf the FM patients, 79 (11.8%) were statin users, whereas 589 (88.2%) reported no current statin use. Compared with the control cohort, statin users were older (55.0±11.3 years vs 46.2±12.9 years; P<.001) and had a higher body mass index (33.0±7.0 kg/m2 vs 29.8±7.7 kg/m2; P=.001). Adjusted linear regression revealed no association between statin use and symptom severity (total FIQ-R scores, 57.7±18.3 vs 59.0±18.1; adjusted β coefficient, −0.4; 95% CI, −4.8 to 4.1; P=.871). There was also no association between statin use and tender point count (14.8±4.1 vs 14.5±4.2; adjusted β coefficient, 0.2; 95% CI, −0.8 to 1.2; P=.732). Secondary outcome analysis revealed no difference between statin users and statin nonusers in metrics measuring fatigue, cognition, anxiety, depression, and sleep problems.ConclusionAdministration of statin therapy for at least 1 month is not a risk factor for worse symptom burden in patients with FM. Statin therapy should be offered to dyslipidemic FM patients with an appropriate medical indication to optimize their cardiovascular health.
Highlights
There was an association of older age (P
Both unadjusted and adjusted linear regression analysis did not reveal any difference in fatigue, cognition, anxiety, depression, or sleep problems between statin users and statin nonusers
Concordant with this observation, there were no differences in other secondary outcomes, including fatigue, cognition, mood, and sleep issues. This highlights that patients with FM, a population that already experiences generalized musculoskeletal pain and diffuse tender points, may not be at increased risk of experiencing worse muscle tenderness, increased tender points, or other detrimental clinical outcomes after statin therapy administration
Summary
Population of Patients This study was approved by Mayo Clinic Institutional Review Board. This was a prospective questionnaire study that included 668 patients with FM who were evaluated at the Fibromyalgia Clinic within a tertiary referral center (Mayo Clinic, Rochester, Minnesota) between May 2012 and November 2013. Outcomes of Interest The primary outcomes included FM symptom severity as measured by the Revised Fibromyalgia Impact Questionnaire (FIQ-R) and tender point count. The FIQ-R consists of 21 questionnaire items that assess FM symptom severity, functional status, and overall impact of FM. Higher scores on the FIQ-R designate more severe symptom burden. Scores of 0 to less than 39, 39 to less than 59, and 59 to 100 designate mild, moderate, and severe symptom burden, respectively.[17]
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