Muscle Disorder Risk Is Low for Most Statins

A study of 252, 460 patients taking lipid-lowering medications (ie, atorvastatin,pravastatin, and simvastatin) for cholesterol showed a moderately lowrisk of developing rhabdomyolysis—a disorder that results in the breakdownof muscle. Reporting in the Journal of the American Medical Association(December 1, 2004), the researchers discovered, however, that older patientswith diabetes mellitus taking combined statin-fibrate therapy seemed atgreater risk for rhabdomyolysis. Furthermore, the patients who were takingcerivastatin combined with fibrates had an even higher risk—about 1 in 10treated patients a year.

Of all the patients being treated with cholesterol-lowering drugs, only 24cases of hospitalized rhabdomyolysis happened during treatment. All of thepatients with rhabdomyolysis were taking daily dosages of statins within thedose range suggested in product labeling. "Compared with statin monotherapy,fibrate use was associated with a 5.5-fold increase in risk, and the combineduse of a statin and fibrate increased risk by an additional 2-fold versusfibrate alone,"said the study authors. "The risk of rhabdomyolysis withcerivastatin monotherapy was 10-fold greater than with other statins and, incombination with a fibrate, was increased more than 1400-fold."