Drug-related Myopathies of Which the Clinician Should Be Aware

Abstract

Many drugs used for therapeutic interventions can cause unanticipated toxicity in muscle tissue, often leading to considerable morbidity. A drug-induced, or toxic, myopathy is defined as the acute or subacute manifestation of myopathic symptoms such as muscle weakness, myalgia, creatine kinase elevation, or myoglobinuria that can occur in patients without muscle disease when they are exposed to certain drugs. A brief review of agents with a known association with myotoxicity and the proposed mechanisms linked to that toxicity is outlined; however, the purpose of this review is to highlight recent discoveries and advances in the field of toxic myopathies that have practical implications for practicing physicians. Because many drug-related myopathies are potentially reversible at early stages, it is important for clinicians to recognize toxic myopathies early in their course to determine when to discontinue therapy and potentially prevent irreversible muscle damage.

ERS International Congress 2017: a peek of outstanding abstracts from the clinical assembly

“…After lung-transplantation, further worsening of skeletal muscle is likely to be occurred as a consequence of immunosuppressant medications (33). For instance, steroidassociated myopathy is related to muscular atrophy, which can be due to suppressed protein synthesis and growth, enhanced proteolysis, and apoptosis induction, therefore affecting the muscle condition of long-term LTx patients (34). Consequently, neuromuscular adaptations including improvements in balance and muscle power as positive effects of WBVT (35) could be highly beneficial to lungtransplanted patients.…”

A Reversible Cardiomyopathy?

“…There are many causes of reversible myopathy like, due to drugs like statins, or due to hypocalcaemia or hypokalaemia, due to hypothyroidism, or due to hyperthyroidism or due to mitochondrial myopathies that occur in children, or infants. 18,19 The main features of reversible myopathies are that they have an acute onset .So in an acute heart failure with muscle weakness, reversible causes of myopathy should be looked for. Generally hereditary degenerative myopathies develop slowly over a long period.…”

Atteinte musculaire et glucocorticoïdes

“…Tr ès fréquemment prescrits dans de nombreuses maladies, les corticoïdes sont parmi les plus connus des myotoxines, bien que les mécanismes de leur toxicité musculaire restent obscurs [1]). L'atteinte musculaire liée aux glucocorticoïdes est classiquement décrite lors des traitements prolongés mais elle reste méconnue dans la plupart de ses aspects, que ce soit dans son évaluation, ses facteurs de risque ou son traitement [2].…”