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A comprehensive review and meta-analysis of risk factors for statin-induced myopathy

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Abstract

Purpose

To aid prescribers in assessing a patient’s risk for statin-induced myopathy (SIM), we performed a comprehensive review of currently known risk factors and calculated aggregated odds ratios for each risk factor through a meta-analysis.

Methods

This meta-analysis was done through four phases: (1) Identification of the relevant primary literature; (2) abstract screening using inclusion and exclusion criteria; (3) detailed review and data extraction; and (4) synthesis and statistical analysis.

Results

Out of 44 papers analyzed from 836 papers searched from MEDLINE, 18 different potential risk factors were collected, divided into three categories: three demographics (11 papers), ten clinical factors (31 papers), and five pharmacogenetics/biomarkers (12 papers). Risk factors significant for myopathy and/or rhabdomyolysis included age, gender, diabetes, renal impairment, cardiovascular disease, certain interacting drugs, and mutations of the SLCO1B1 gene, which encodes a transporter protein in the liver. Several factors, such as gender, race, cardiovascular disease, and the GATM gene, which encodes a protein for creatine synthesis, appeared to be protective in terms of the outcomes of interest.

Conclusions

This comprehensive assessment of risk factors can help support clinicians in reducing the incidence of SIM in their patient population on statins.

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Acknowledgements

This work was made possible by the support of Clem MacDonald chair account and by Lilly Endowment Inc. Physician Scientist Initiative. We gratefully acknowledge Lane Coffee’s help with manuscript preparation, and Sandy Poremba’s and Lisa Gill’s in preparing the bibliography.

Funding

This work was further supported by VA HSR&D grant CIN 13-416 at the Richard L. Roudebush Veterans Affairs Medical Center in Indianapolis, Indiana.

Author information

Authors and Affiliations

  1. Center for Health Information and Communication, Department of Veterans Affairs (VA), Veterans Health Administration, Health Service Research and Development Service (CIN 13-416), Richard L. Roudebush VA Medical Center, D6004-02, 1481 West 10th Street, Indianapolis, IN, 46202, USA

    Khoa A. Nguyen

  2. Department of Pharmacy Practice, College of Pharmacy, Purdue University, Indianapolis, IN, USA

    Khoa A. Nguyen

  3. Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, USA

    Lang Li & Lei Wang

  4. Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Deshun Lu

  5. Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA

    Aida Yazdanparast

  6. Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA

    Rolf P. Kreutz

  7. Research and Translational Sciences, Indiana University School of Medicine, Indianapolis, IN, USA

    Elizabeth C. Whipple

  8. Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Titus K. Schleyer

  9. Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, IN, USA

    Titus K. Schleyer

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  1. Khoa A. Nguyen
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  2. Lang Li
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Correspondence to Khoa A. Nguyen.

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Nguyen, K.A., Li, L., Lu, D. et al. A comprehensive review and meta-analysis of risk factors for statin-induced myopathy. Eur J Clin Pharmacol 74, 1099–1109 (2018). https://doi.org/10.1007/s00228-018-2482-9

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  • DOI: https://doi.org/10.1007/s00228-018-2482-9

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