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Increased exposure to statins in patients developing chronic muscle diseases. A 2-year retrospective study.
  1. L Sailler (sailler.l{at}chu-toulouse.fr)
  1. EA3696, Laboratoire de Pharmacoépidémiologie, Faculté de Médecine, Toulouse, France
    1. C Pereira
    1. EA3696, Laboratoire de Pharmacoépidémiologie, Faculté de Médecine, Toulouse, France
      1. A Bagheri
      1. Centre Régional de Pharmacovigilance, Faculté de Médecine, Toulouse, France
        1. E Uro-Coste
        1. Laboratoire d'Anatomo-pathologie, CHU de Rangueil,Toulouse, France
          1. H Roussel
          1. Caisse Régionale d’Assurance Maladie, Toulouse, France
            1. D Adoue
            1. Service de Médecine Interne, Pavillon des Médecines, CHU Purpan, France
              1. B Fournié
              1. Service de Rhumatologie, CHU Purpan, Toulouse, France
                1. M Laroche
                1. Service de Rhumatologie, CHU Rangueil, Toulouse, France
                  1. L Zabraniecki
                  1. Service de Rhumatologie, CHU Purpan, Toulouse, France
                    1. P Cintas
                    1. Service de Neurologie, CHU Rangueil, Toulouse, France
                      1. P Arlet
                      1. CHU Purpan, France
                        1. E Arlet-Suau
                        1. CHU Purpan, France
                          1. M Lapeyre-Mestre
                          1. EA3696, Laboratoire de Pharmacoépidémiologie, Faculté de Médecine, Toulouse, France
                            1. J-L Montastruc
                            1. Service de Pharmacologie Clinique, Faculté de Médecine, Toulouse, France

                              Abstract

                              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

                              • dermatomyositis
                              • muscle
                              • polymyositis
                              • statin
                              • toxicity

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                                BMJ Publishing Group Ltd and European League Against Rheumatism