Association of statin induced reduction in serum coenzyme Q10 level and conduction deficits in motor and sensory nerves: An observational cross-sectional study

Gurha, Neha; Rehan, Harmeet Singh; Yadav, Madhur; Gupta, Lalit

doi:10.1016/j.clineuro.2020.106046

Cited by 6 publications

(4 citation statements)

References 23 publications

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“…Of the 50 statin patients, 29 had impaired sural, tibial and common peroneal nerve conduction, and had low mean serum CoQ10 levels. And statin users were more likely to have impaired nerve conduction than healthy volunteers 25 . This finding was confirmed by an in vitro study of neuronal growth retardation, synaptic formation, reduced neuronal interaction, chemical and electrical signalling defects, and cell death in lipid‐free cultures induced by HMGCR inhibitors 26 .…”

Section: What Is Known and Objectivementioning

confidence: 68%

The association between statins exposure and peripheral neuropathy risk: A meta‐analysis

Wang

Xie

2021

J Clin Pharm Ther

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What is known and objective Statins are widely used lipid‐lowering drugs and play an important role in the treatment of many cardiovascular diseases. With the increase in the scope of use and the number of users, peripheral neuropathy caused by statins has been frequently reported. There are no randomized controlled trials comparing the relationship between statins and the risk of peripheral neuropathy. Therefore, we systematically reviewed and meta‐analysed observational studies evaluating the impact of statins on the risk of peripheral neuropathy. Methods PubMed, Embase, the Cochrane Library databases and Web of Science were used to search the effects of statins on polyneuropathy from inception to 3 December 2020. We included studies that met the following criteria: (i) A randomized controlled trial, prospective or retrospective cohort study examining the relationship between statins and peripheral neuropathy (PN). Exclusion criteria included the following: Reviews and research related to other diseases or subjects; and studies without data on the prevalence of PN were excluded. Newcastle‐Ottawa scale (NOS) was used for quality assessment of included studies. Meta‐analysis was used to estimate the risk of disease. We conducted a subgroup analysis of duration of follow‐up, adjusted (adjusted RR vs. unadjusted RR), sample size, study design and region. Results and discussion A total of 9 independent studies assessing 150 556 patients were included in this analysis. In this meta‐analysis, we found that there was a nonsignificant increase of PN with statins exposure (RR 1.26, 95% CI (0.92‐1.74)). Our results revealed that there was no significant association between statins exposure and peripheral neuropathy risk. What is new and conclusion Statins exposure does not influence the risk of developing peripheral neuropathy. The quality of the evidence included in this study is low, but it can provide useful information for clinicians.

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Section: What Is Known and Objectivementioning

confidence: 68%

The association between statins exposure and peripheral neuropathy risk: A meta‐analysis

Wang

Xie

2021

J Clin Pharm Ther

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“…Theoretically, a class effect of HMG‐CoA reductase inhibition interferes with cholesterol synthesis, which may alter cell membrane function and interfere with myelin sheath formation, causing peripheral nerve dysfunction 20‐22 . In addition, statins can reduce the synthesis of ubiquinone or Coenzyme Q10, which affects the mitochondrial respiratory chain and energy utilization in nervous tissue 21‐24 . Dyslipidemia itself is also a risk factor for PN and, thus, the possibility of confounding by indication.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22] In addition, statins can reduce the synthesis of ubiquinone or Coenzyme Q10, which affects the mitochondrial respiratory chain and energy utilization in nervous tissue. [21][22][23][24] Dyslipidemia itself is also a risk factor for PN and, thus, the possibility of confounding by indication.…”

Section: Publication Biasmentioning

confidence: 99%

Statins and the risk of polyneuropathy: A systematic review and two meta‐analyses

et al. 2021

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Introduction/Aims Previous studies have shown inconsistent data on the relationship between statin use and polyneuropathy (PN). The current systematic review and meta‐analyses were conducted to comprehensively investigate the risk of incident PN among statin‐users compared with non‐users by identifying all available studies and summarizing their results. Methods A systematic review was conducted from MEDLINE and EMBASE databases from inception to October 31, 2020. We included cohort and case–control studies that compared the risk of incident PN between statin‐users and non‐users. Point estimates and standard errors from eligible studies were pooled together using the generic inverse variance method. Results Of 4968 retrieved articles, 6 studies in non‐diabetic populations and 2 studies in diabetic populations fulfilled the inclusion criteria. Two meta‐analyses were performed. The pooled analyses did not find a statistically significant association between the use of statins and risk of incident PN with the pooled odds ratio of 1.24 (95% confidence interval [CI], 0.88–1.76; I2 74%) and 0.82 (95% CI, 0.56–1.21; I2 80%) in non‐diabetic and diabetic groups respectively. Discussion No significant association between the use of statins and the risk of PN was observed in this systematic review and these two meta‐analyses. However, there was a high degree of heterogeneity of the meta‐analyses.

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“…Gurha et al found that the reduction of CoQ10 levels in blood might have been responsible for the onset of a peripheral neuropathy, demonstrated by nerve conduction alterations [ 45 ].…”

Section: Statins and Peripheral Neuropathymentioning

confidence: 99%

Statins Neuromuscular Adverse Effects

Attardo

Musumeci

Velardo

et al. 2022

IJMS

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Statins are drugs widely prescribed in high-risk patients for cerebrovascular or cardiovascular diseases and are, usually, safe and well tolerated. However, these drugs sometimes may cause neuromuscular side effects that represent about two-third of all adverse events. Muscle-related adverse events include cramps, myalgia, weakness, immune-mediated necrotizing myopathy and, more rarely, rhabdomyolysis. Moreover, they may lead to peripheral neuropathy and induce or unmask a preexisting neuromuscular junction dysfunction. A clinical follow up of patients assuming statins could reveal early side effects that may cause neuromuscular damage and suggest how to better modulate their use. In fact, statin dechallenge or cessation, or the alternative use of other lipid-lowering agents, can avoid adverse events. This review summarizes the current knowledge on statin-associated neuromuscular adverse effects, diagnosis, and management. It is conceivable that the incidence of neuromuscular complications will increase because, nowadays, use of statins is even more diffused than in the past. On this purpose, it is expected that pharmacogenomic and environmental studies will help to timely predict neuromuscular complications due to statin exposure, leading to a more personalized therapeutic approach.

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Association of statin induced reduction in serum coenzyme Q10 level and conduction deficits in motor and sensory nerves: An observational cross-sectional study

Cited by 6 publications

References 23 publications

The association between statins exposure and peripheral neuropathy risk: A meta‐analysis

The association between statins exposure and peripheral neuropathy risk: A meta‐analysis

Statins and the risk of polyneuropathy: A systematic review and two meta‐analyses

Statins Neuromuscular Adverse Effects

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