Understanding The Link Between Statins And Muscle Damage

| September 7, 2012

Statins can have a wide range of adverse effects on the body, but perhaps most well known is their ability to damage and cause pain in the muscles. It’s difficult to know how many people may be affected, because as I have pointed out previously, many studies eliminate individuals prone to side-effects before the study gets properly underway. Plus, researchers often ensure the bar for what is regarded as a significant issue is set very high. That means many individuals with genuine problems simply won’t make it into the side-effect data.

Recently, a group of researchers made an attempt to better understand the muscle-related side effects of statins, and whether different statins have different effects here [1]. The data they drew on came from the Food and Drugs Administration’s (FDA) ‘Adverse Events Reporting System’ in the US. The researchers looked at data from a six-year period (2005-2011) during which there were about 148,000 reports of muscle-related problems put down to statins. It should be perhaps borne in mind that the real number of adverse events are much higher in the real world. It’s thought the majority of adverse events go unrecognised or unreported.

The researchers looked at the adverse effects of several different statins. What they found was that the more ‘potent’ a statin, the more likely individuals were to have muscle-related side-effects. The worst statin in terms of side-effects was rosuvastatin (Crestor). The next most problematic statin was atorvastatin (Lipitor), followed by simvastatin (Zocor), pravastatin (Pravachol), and lovastatin (Mevachor).

Statins work by inhibiting an enzyme (known as HMG-coA reductase) responsible for the manufacture of cholesterol in the liver. However, that enzyme is also responsible for the production of the nutrient coenzyme Q10, which plays a role in energy production in the body. Some people have speculated that at least some of the side-effects of statins are related to their capacity to deplete the body of coenzyme Q10. It stands to reason then that drugs that are more potent inhibitors of HMG-coA reductase will be more effective at lowering both cholesterol and coenzyme Q10. This might possible explain why the risk of side effects is greater with more potent statins.

One of the authors of the study, Professor Beatrice Golomb, makes the point that stronger statins more capable of lowering cholesterol are not necessarily more effective at, say, reducing the risk of death in people with known heart disease. The suggestion, therefore, is that more potent statins do not have significant benefits over less potent ones, and that the fact that they are more likely to give rise to side-effects means they should be prescribed with care. Professor Golomb is quoted as saying: “These findings underscore that stronger statins bear higher risk – and should be used with greater caution and circumspection.”

Here’s to a healthy heart

Dr John Briffa
Editor
for The Cholesterol Truth



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Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.


References:

1: Hoffman KB, et al. A Survey of the FDA’s AERS Database Regarding Muscle and Tendon Adverse Events Linked to the Statin Drug Class. PLoS One. 2012;7(8):e42866. Epub 2012 Aug 22.

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Category: Statin Drugs Side Effects, What Doctors Don't Tell You

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