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 in the Toulouse University Hospital between January 2003 and December 2004 among patients living in the Midi-Pyrénées area. All patients remained symptomatic 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: Thirty-seven patients were included in the study. Twenty-one (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: 2.73 [IC95%: 1.21-6.14] p<0.01). There was a significant positive interaction between statins and proton pump inhibitors exposure (weighted OR 3.3 [1.37-7.54]; p=0.02). Statins exposure rate was 47.6% among DM/PM patients (OR= 3.86 [IC95: 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