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statin myopathy

Thomas Schwartz, Louise Pyndt Diederichsen, Ingrid E Lundberg, Ivar Sjaastad, Helga Sanner
Idiopathic inflammatory myopathies (IIM) include the main subgroups polymyositis (PM), dermatomyositis (DM), inclusion body myositis (IBM) and juvenile DM (JDM). The mentioned subgroups are characterised by inflammation of skeletal muscles leading to muscle weakness and other organs can also be affected as well. Even though clinically significant heart involvement is uncommon, heart disease is one of the major causes of death in IIM. Recent studies show an increased prevalence of traditional cardiovascular risk factors in JDM and DM/PM, which need attention...
2016: RMD Open
Annalisa Bonifacio, Gerda M Sanvee, Karin Brecht, Denise V Kratschmar, Alex Odermatt, Jamal Bouitbir, Stephan Krähenbühl
Statins are generally well tolerated, but treatment with these drugs may be associated with myopathy. The mechanisms of statin-associated myopathy are not completely understood. Statins inhibit AKT phosphorylation by an unclear mechanism, whereas insulin-like growth factor (IGF-1) activates the IGF-1/AKT signaling pathway and promotes muscle growth. The aims of the study were to investigate mechanisms of impaired AKT phosphorylation by simvastatin and to assess effects of IGF-1 on simvastatin-induced myotoxicity in C2C12 myotubes...
October 12, 2016: Archives of Toxicology
Jesús Millán, Juan Pedro-Botet, Elisenda Climent, Joaquín Millán, Joan Rius
BACKGROUND AND OBJECTIVE: Muscle symptoms, with or without elevation of creatin kinase are one of the main adverse effects of statin therapy, a fact that sometimes limits their use. The aim of this study was to evaluate the clinical characteristics of patients treated with statins who have complained muscle symptoms and to identify possible predictive factors. PATIENTS AND METHODS: A cross-sectional one-visit, non-interventional, national multicenter study including patients of both sexes over 18 years of age referred for past or present muscle symptoms associated with statin therapy was conducted...
October 4, 2016: Clínica e Investigación en Arteriosclerosis
Johannes M Just, Klaus Weckbecker, Katja S Just
BACKGROUND: Nocturnal leg cramps are painful, involuntary muscle contractions commonly seen in elderly. While mostly harmless, they can severely impair quality of life and often disrupt sleep. Adverse drug effects may be responsible for a fraction of nocturnal leg cramps but often go unrecognized, resulting in additional prescribing intended to deal with adverse effects that might be better addressed by reduction, substitution, or discontinuation of the offending agent. CASE PRESENTATION: An 87 year old female presented as outpatient in family medicine with nocturnal leg cramps which had been present for five years and increasingly burdened her quality of life...
October 1, 2016: BMC Geriatrics
Sze Ling Chan, Mun Yee Tham, Siew Har Tan, Celine Loke, Belinda Foo, Yanping Fan, Pei San Ang, Liam R Brunham, Cynthia Sung
The aim of this study was to develop and validate sensitive algorithms to detect hospitalized statin-induced myopathy (SIM) cases from electronic medical records (EMRs). We developed 4 algorithms on a training set of 31,211 patient records from a large tertiary hospital. We determined the performance of these algorithms against manually curated records. The best algorithm used a combination of elevated creatine kinase (>4x upper limit of normal), discharge summary, diagnosis, and absence of statin in discharge medications...
October 5, 2016: Clinical Pharmacology and Therapeutics
Catherine Ashton, Reimar Junckerstorff, Chris Bundell, Peter Hollingsworth, Merrilee Needham
Necrotising Autoimmune Myopathy (NAM) presents as a subacute proximal myopathy with high creatine kinase levels. It is associated with statin exposure, 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody, connective tissue diseases, signal recognition particle (SRP) antibody and malignancy. This case series presents our Western Australian NAM patient cohort: comparing the subgroup presentations, biopsy appearance and treatment outcomes. We retrospectively collected data on patients diagnosed with NAM at the Western Australian Neuroscience Research Institute between the years 2000 and 2015...
September 3, 2016: Neuromuscular Disorders: NMD
Matthew B Carroll, Michelle R Newkirk, Nathan S Sumner
Necrotizing autoimmune myopathy (NAM) is a recently recognized entity within the spectrum of idiopathic inflammatory myopathies. Diagnosis critically rests on histopathologic demonstration of macrophage predominant myocyte destruction, with few to no lymphocytes. We report our experience with identifying and treating this subset of inflammatory myositis, highlighting the importance of muscle biopsy in diagnosis, association with statin use and malignancy, and challenges of therapy.We present 3 cases that presented to 2 hospitals within our academic system in calendar year 2014 with acute/subacute onset of profound proximal muscle weakness and markedly elevated creatine kinase levels...
October 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Juan Pedro-Botet, Jesús Millán Núñez-Cortés, Juan J Chillarón, Juana A Flores-Le Roux, Joan Rius
OBJECTIVE: To describe the severity of muscle injury (myalgia, myositis and rhabdomyolysis) and associated conditions related to statin therapy that may be clinically significant. RESEARCH DESIGN AND METHODS: A cross-sectional one-visit, non-interventional, national multicenter study including patients of both sexes over 18 years of age referred for past or present muscle symptoms associated with statin therapy was conducted. Clinical, biochemical and drug therapy characteristics were obtained at the initial evaluation...
September 20, 2016: Expert Opinion on Drug Safety
M Alvarado-Cardenas, A Marin, M A Martínez, L Martínez, I Pinal-Fernandez, M Labrador-Horrillo, E Balada, X Mundet-Tuduri, L Gonzalez-Mera, J Casademont, E Martínez Acebes, P J Moreno, C Juarez, J M Grau-Junyent, R Pujol-Borrell, A Selva-O'Callaghan
BACKGROUND AND OBJECTIVE: Statin-associated autoimmune myopathy (SAAM) with anti-HMGCR antibodies has recently been described. Several specific immunoassays are in use to detect HMGCR antibodies. In the course of systematic autoantibody screening we recognized a new distinct IFL staining pattern on rat liver sections that regularly coincided with anti-HMGCR antibodies. In this study we investigated whether this new IFL pattern is specifically associated to statin-associated autoimmune myopathy and corresponds to anti-HMGCR antibodies...
September 15, 2016: Autoimmunity Reviews
Unn Ljøstad, Åse Mygland
It is well known that statins can have a toxic effect on musculature, but less widely known that they can also trigger progressive autoimmune myopathy. Statin-associated autoimmune myopathy is characterised by proximal muscle weakness, antibodies to 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) in serum, and necrosis without lymphocytic infiltration on muscle biopsy.
September 2016: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Danina M Muntean, Paul D Thompson, Alberico L Catapano, Mariusz Stasiolek, Jaroslaw Fabis, Paul Muntner, Maria-Corina Serban, Maciej Banach
Over the past three decades, statins have become the cornerstone of prevention and treatment of atherosclerotic cardiovascular and metabolic diseases. Albeit generally well tolerated, these drugs can elicit a variety of muscle-associated symptoms that represent the most important reason for treatment discontinuation. Statin-associated myopathy has been systematically underestimated by randomized controlled trials as compared with the incidence observed in clinical practice and obtained from patient registries...
September 12, 2016: Drug Discovery Today
O Shovman, B Gilburd, C Chayat, A Dortort Lazar, H Amital, M Blank, C Bentow, M Mahler, Y Shoenfeld
Anti-HMGCR antibodies represent a characteristic serological feature of statin-exposed and statin-unexposed patients with immune-mediated necrotizing myopathy (IMNM). We assessed anti-HMGCR antibodies in patients with suspected IMNM following statin exposure and patients with other autoimmune rheumatic diseases. We evaluated the presence of anti-HMGCR autoantibodies in sera samples from 13 statin-exposed patients who were suspected of having IMNM, 38 patients with different inflammatory and autoimmune rheumatic diseases and 29 healthy subjects...
September 12, 2016: Immunologic Research
Rory Collins, Christina Reith, Jonathan Emberson, Jane Armitage, Colin Baigent, Lisa Blackwell, Roger Blumenthal, John Danesh, George Davey Smith, David DeMets, Stephen Evans, Malcolm Law, Stephen MacMahon, Seth Martin, Bruce Neal, Neil Poulter, David Preiss, Paul Ridker, Ian Roberts, Anthony Rodgers, Peter Sandercock, Kenneth Schulz, Peter Sever, John Simes, Liam Smeeth, Nicholas Wald, Salim Yusuf, Richard Peto
This Review is intended to help clinicians, patients, and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomised controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment...
September 6, 2016: Lancet
Iago Pinal-Fernandez, Andrew L Mammen
PURPOSE OF REVIEW: This review aims to describe the spectrum of clinical, histological, and serological features in patients with immune-mediated necrotizing myopathies (IMNMs). RECENT FINDINGS: Autoantibodies recognizing the signal recognition particle (SRP) or 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) define two unique subtypes of necrotizing myositis patient with distinct clinical features. For example, the major histocompatibility class II human leukocyte antigen allele DRB111:01 is a strong immunogenetic risk factor for developing anti-HMGCR autoantibodies whereas B5001 and DQA10104 are over-represented in patients with anti-SRP autoantibodies...
November 2016: Current Opinion in Rheumatology
Evan W Colmenares, Ashley L Pappas
OBJECTIVE: The purpose of this article is to describe the relationship between proton pump inhibitors (PPIs) and symptoms of myopathy based on case reports. DATA SOURCES: A literature search was conducted in PubMed (1946 to June 2016) using MeSH terms proton pump inhibitors, omeprazole, esomeprazole, lansoprazole, dexlansoprazole, rabeprazole, pantoprazole, and muscular diseases Additionally, a search was conducted in ToxNet and EMBASE using similar search criteria...
August 18, 2016: Annals of Pharmacotherapy
V Stránecký, M Neřoldová, K Hodaňová, H Hartmannová, L Piherová, P Zemánková, A Přistoupilová, M Vrablík, V Adámková, S Kmoch, M Jirsa
Some patients are susceptible to statin-associated myopathy (SAM) either because of genetic variations affecting statin uptake and metabolism, or because they predispose their carriers to muscular diseases. Among the frequent variants examined using the genome-wide association study approach, SLCO1B1 c.521T>C represents the only validated predictor of SAM in patients treated with high-dose simvastatin. Our aim was to ascertain the overall contribution of large copy-number variations (CNVs) to SAM diagnosed in 86 patients...
August 19, 2016: Physiological Research
Michael D George, Neilia-Kay McGill, Joshua F Baker
BACKGROUND: Creatine kinase (CK) values are a critical part of the workup of suspected myopathies and are often assessed in patients that develop myalgia on statin therapy. CK elevations may influence the initiation and cessation of statin treatment, and incidentally discovered CK elevation may lead to further testing. A number of factors influence CK levels in healthy patients, but current reference ranges do not incorporate important influencers of CK such as race. Objectives of this study were to evaluate clinical factors associated with CK among healthy individuals and to develop practical reference ranges for important subgroups to improve test interpretation...
August 2016: Medicine (Baltimore)
C Menni, S Metrustry, G Ehret, A F Dominiczak, P Chowienczyk, T D Spector, S Padmanabhan, A M Valdes
OBJECTIVE: The dicarboxylic fatty acid hexadecanedioate is functionally associated with increased blood pressure. The aims of this study was to further characterize which pathways are related to this compound using genetic and transcriptomic data. DESIGN AND METHOD: A genome-wide association scan (GWAS) was conducted on 6447 individuals from the TwinsUK and KORA cohorts. SNPs achieving genome-wide significance were then tested in the International Consortium for Blood Pressure and in a GWAS of extremes of blood pressure...
September 2016: Journal of Hypertension
Gustavs Latkovskis, Vita Saripo, Emma Sokolova, Dana Upite, Ilona Vanaga, Ugis Kletnieks, Andrejs Erglis
BACKGROUND AND OBJECTIVE: Statin-induced myopathy (SIM) has been partially attributed to deficiency of dolichol and coenzyme Q10 (CoQ10). We aimed to test the safety and efficacy of plant polyprenols in combination with CoQ10 for alleviation of SIM. MATERIALS AND METHODS: In an open-label, one-center prospective pilot study patients with SIM received conifer-tree needle polyprenols (4mg/day) and CoQ10 (100mg/day) for 8 weeks. Symptoms and safety were evaluated according to symptom severity score (0-10), creatine kinase (CK) levels, exercise test, dynamometry, complete blood count, clinical biochemistry and electrocardiography...
2016: Medicina
Lucile Musset, Yves Allenbach, Olivier Benveniste, Olivier Boyer, Xavier Bossuyt, Chelsea Bentow, Joe Phillips, Andrew Mammen, Philip Van Damme, René Westhovens, Anna Ghirardello, Andrea Doria, May Y Choi, Marvin J Fritzler, Heinrike Schmeling, Yoshinao Muro, Ignacio García-De La Torre, Miguel A Ortiz-Villalvazo, Nicola Bizzaro, Maria Infantino, Tiziana Imbastaro, Qinglin Peng, Guochun Wang, Jiří Vencovský, Martin Klein, Olga Krystufkova, Franco Franceschini, Micaela Fredi, Sophie Hue, Thibaut Belmondo, Katalin Danko, Michael Mahler
In an effort to find naturally occurring substances that reduce cholesterol by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR), statins were first discovered by Endo in 1972. With the widespread prescription and use of statins to decrease morbidity from myocardial infarction and stroke, it was noted that approximately 5% of all statin users experienced muscle pain and weakness during treatment. In a smaller proportion of patients, the myopathy progressed to severe morbidity marked by proximal weakness and severe muscle wasting...
October 2016: Autoimmunity Reviews
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