RESEARCH - Increased exposure to statins in patients developing chronic muscle diseases

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Published Online First: 3 September 2007. doi:10.1136/ard.2007.075523

ls of the Rheumatic Diseases 2008;67:614-619

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EXTENDED REPORTS

Increased exposure to statins in patients developing chronic muscle

diseases: a 2-year retrospective study

L Sailler 1, C Pereira 1, A Bagheri 1, M Lapeyre-Mestre 1, J L

Montastruc 1, P Arlet 2, E Arlet-Suau 2, E Uro-Coste 3, H Roussel 4, D

Adoue 5, B Fournie 6, L Zabraniecki 6, M Laroche 7, P Cintas 8

1 University of Tolouse, Toulouse, France

2 Internal Medicine Department, Salles Le Tallec-Tapie, Pavillon

Dieulafoy, CHU Purpan, Toulouse, France

3 Pathology Department, CHU Rangueil, Toulouse, France

4 Direction Régionale du Service Médical, CNAMTS, Toulouse, France

5 Internal Medicine Department, Pavillon des Médecines, CHU Purpan,

Toulouse, France

6 Rheumatology Department, CHU Purpan, Toulouse, France

7 Rheumatology Department, CHU Rangueil, Toulouse, France

8 Neurology Department, CHU Rangueil, Toulouse, France

Objective: Case reports have suggested that lipid-lowering drugs

(LLDs), especially statins, could induce or reveal chronic muscle

diseases. We conducted a study to evaluate the association between

chronic muscle diseases and prior exposure to LLDs.

Method: This was a retrospective study of chronic primary muscle

disease cases newly diagnosed at the Toulouse University Hospitals

between January 2003 and December 2004 among patients living in the

Midi-Pyrénées area, France. All patients remained symptomatic for more

than 1 year after drug withdrawal, or required drugs for inflammatory

myopathy. Data on the patient's exposure to LLDs and to other drugs

were compared with that of matched controls (5/1) selected through the

Midi-Pyrénées Health Insurance System database.

Results: A total of 37 patients were included in the study. Of those,

21 (56.8%) suffered from dermatomyositis (DM) or polymyositis (PM), 12

(32.4%) from genetic myopathy, and 4 (10.8%) from an unclassified

disease. The prevalence of exposure to statins was 40.5% in patients

and 20% in controls (odds ratio (OR) 2.73, 95% confidence interval

(CI) 1.21–6.14; p<0.01). There was a significant positive interaction

between statins and proton pump inhibitors exposure (weighted OR 3.3,

95% CI 1.37–7.54; p = 0.02). Statin exposure rate was 47.6% among

patients with DM/PM (OR 3.86, 95% CI 1.30–11.57; p<0.01). There was no

difference between patients and controls for exposure to fibrates.

Conclusion: Patients who developed chronic muscle diseases after the

age of 50, including DM/PM, had a higher than expected frequency of

prior exposure to statins. Further studies are needed to confirm this

association and the role of proton pump inhibitors.

http://ard.bmj.com/cgi/content/abstract/67/5/614?etoc

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