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.
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.
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.
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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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.
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.
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The authors declare that they have no conflicts of interest.
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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
- Risk factors
- Comprehensive review
- Statin-induced myopathy