Association of Statin Use With Risk of Back Disorder Diagnoses

Makris, Una E.; Wei, Wei; Mortensen, Eric M.; Mansi, Ishak A.

doi:10.1001/jamainternmed.2017.1068

Cited by 6 publications

(4 citation statements)

References 6 publications

(35 reference statements)

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“…They described an inversely proportional relationship between the dose of statins prescribed to patients suffering from hypercholesterolemia and the risk of SDJD occurrence 119 . Contrary to the previous reports, a higher risk of developing low back pain was associated with the higher dosage of statins, which tended to cause statin-induced myopathy 120 . With respect to the in vivo and clinical studies, the application of biological treatment strategies for the regeneration of IVDs remains a largely undiscovered field which has great potential for further investigations.…”

Section: Small Molecules and Ivd Regenerationcontrasting

confidence: 91%

Small molecule-based treatment approaches for intervertebral disc degeneration: Current options and future directions

et al. 2021

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Low back pain (LBP) is a major reason for disability, and symptomatic intervertebral disc (IVD) degeneration (IDD) contributes to roughly 40% of all LBP cases. Current treatment modalities for IDD include conservative and surgical strategies. Unfortunately, there is a significant number of patients in which conventional therapies fail with the result that these patients remain suffering from chronic pain and disability. Furthermore, none of the current therapies successfully address the underlying biological problem - the symptomatic degenerated disc. Both spinal fusion as well as total disc replacement devices reduce spinal motion and are associated with adjacent segment disease. Thus, there is an unmet need for novel and stage-adjusted therapies to combat IDD. Several new treatment options aiming to regenerate the IVD are currently under investigation. The most common approaches include tissue engineering, growth factor therapy, gene therapy, and cell-based treatments according to the stage of degeneration. Recently, the regenerative activity of small molecules (low molecular weight organic compounds with less than 900 daltons) on IDD was demonstrated. However, small molecule-based therapy in IDD is still in its infancy due to limited knowledge about the mechanisms that control different cell signaling pathways of IVD homeostasis. Small molecules can act as anti-inflammatory, anti-apoptotic, anti-oxidative, and anabolic agents, which can prevent further degeneration of disc cells and enhance their regeneration. This review pursues to give a comprehensive overview of small molecules, focusing on low molecular weight organic compounds, and their potential utilization in patients with IDD based on recent in vitro , in vivo, and pre-clinical studies.

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Section: Small Molecules and Ivd Regenerationcontrasting

confidence: 91%

Small molecule-based treatment approaches for intervertebral disc degeneration: Current options and future directions

et al. 2021

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“…Previous observational and meta-analysis studies have not been in agreement ( 31 – 33 ) with some studies suggesting no effect ( 34 – 36 ); however, a nested case-control study ( 29 ) reported that statin use could increase the odds of peptic ulcer by 45% in Korea. We also identified 10 other known statin-related AEs in our study: migraine ( 37 – 39 ), sleep disorder ( 40 – 42 ), senile cataract ( 21 , 22 ), disorders of vestibular function ( 43 ), GERD ( 44 ), gouts ( 45 ), gonarthrosis ( 46 , 47 ), spondylosis ( 48 ), osteoporosis ( 49 , 50 ), and cystitis ( 51 ). However, all their associations with statin use were weak in both designs, and the biological shreds of evidence for these findings are unidentified.…”

Section: Discussionmentioning

confidence: 99%

Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study

Ahn,

Lee,

Won

2023

Sci. Adv.

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An extensive evaluation of disease occurrence after statin use based on a “hypothesis-free” approach remains scarce. To examine the effect of statin use on the potential risk of developing diseases, a propensity score–matched cohort study was executed using data from the National Sample Cohort in South Korea. A total of 7847 statin users and 39,235 nonstatin users were included in the final analysis. The period of statin use was defined as our main time-dependent exposure and was divided into three periods: current, recent, and past. The main outcomes were defined as new-onset diseases with ≥100 events based on the International Statistical Classification of Diseases, 10th Revision. We calculated the adjusted hazard ratios and 95% confidence intervals (CIs) using Cox regression. We found that statin use significantly increased the risk of developing iron deficiency anemia up to 5.04 times (95% CI, 2.11 to 12.03). Therefore, the iron levels of patients using statins should be monitored carefully.

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“…Estimates of the number needed to harm (NNH) in retrospective studies have ranged from 19 to 47 for musculoskeletal disorders [ 7 , 16 , 17 ], and statins markedly increase the risk of myopathy [odds ratio (OR): 2.63, 95% confidence interval (CI): 1.50–4.61] [ 18 ]. A recent analysis considered 60,455 military adults in the TRICARE medical program and propensity matched statin users with nonusers [ 19 ]. The statin users (72% used simvastatin) were observed to have a higher likelihood of back disorder diagnosis (OR: 1.27, 95% CI: 1.19–1.36, NNH = 17 at 4 years).…”

Section: Potential For Adverse Effectsmentioning

confidence: 99%

Statin Treatment in Specific Patient Groups: Role for Improved Cardiovascular Risk Markers

White

Mishcon

Redwanski

et al. 2020

JCM

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Ample evidence supports the use of statin therapy for secondary prevention in patients with a history of atherosclerotic cardiovascular disease (ASCVD), but evidence is wanting in the case of primary prevention, low-risk individuals, and elderly adults 65+. Statins are effective in lowering low-density lipoprotein (LDL), which has long been a target for treatment decisions. We discuss the weakening dependence between cholesterol levels and mortality as a function of age and highlight recent findings on lipoprotein subfractions and other superior markers of ASCVD risk. The efficacy of statins is compared for distinct subsets of patients based on age, diabetes, ASCVD, and coronary artery calcium (CAC) status. Most cardiovascular risk calculators heavily weight age and overestimate one’s absolute risk of ASCVD, particularly in very old adults. Improvements in risk assessment enable the identification of specific patient populations that benefit most from statin treatment. Derisking is particularly important for adults over 75, in whom treatment benefits are reduced and adverse musculoskeletal effects are amplified. The CAC score stratifies the benefit effect size obtainable with statins, and forms of coenzyme Q are discussed for improving patient outcomes. Robust risk estimator tools and personalized, evidence-based approaches are needed to optimally reduce cardiovascular events and mortality rates through administration of cholesterol-lowering medications.

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Association of Statin Use With Risk of Back Disorder Diagnoses

Cited by 6 publications

References 6 publications

Small molecule-based treatment approaches for intervertebral disc degeneration: Current options and future directions

Small molecule-based treatment approaches for intervertebral disc degeneration: Current options and future directions

Possible link between statin and iron deficiency anemia: A South Korean nationwide population-based cohort study

Statin Treatment in Specific Patient Groups: Role for Improved Cardiovascular Risk Markers

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