Low serum 25 (OH) vitamin D levels (&lt;32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients

Ahmed, Waqas; Khan, Naveed Ali; Glueck, Charles J.; Pandey, Suman Kumari; Wang, Ping; Goldenberg, Naila; Uppal, Muhammad S.; Khànal, Suraj

doi:10.1016/j.trsl.2008.11.002

Cited by 170 publications

(149 citation statements)

References 25 publications

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“…Our findings support the concept that vitamin D status modifies the effect of statins on musculoskeletal pain [2,8]. Two recent retrospective cohort studies in statin users came to opposite conclusions regarding the association between vitamin D status and myalgia symptoms in patients using statins, with one study finding an association between vitamin D deficiency and incident statin myalgia [6] and the other finding no association [4].…”

Section: Discussionsupporting

confidence: 83%

“…Additionally, we lacked sufficient information to assess variations by statin dose and type, and although myalgia is known to occur with all statins, we were not able to evaluate whether higher doses or specific classes of statins modify the strength of the observed associated between combined statin treatment and low vitamin D status and musculoskeletal pain. Additionally, due to the distribution of vitamin D in our sample, we had limited power to evaluate the possible effects of 25(OH)D concentrations at higher levels that have been observed to improve statin myalgia [2,3]. Finally, while our analyses adjusted for a wide array of lifestyle, dietary, and health status covariates, residual confounding may remain.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Vitamin D status has been proposed to modify the effect of statin use on musculoskeletal pain, with deficient vitamin D increasing the risk of statin-associated musculoskeletal symptoms [2]. However, prior studies have included statin-users only, and have yielded mixed results [2][3][4][5][6]. Therefore, it remains uncertain whether vitamin D deficiency modifies the effect of statin use by increasing the risk of musculoskeletal pain beyond that associated with statin use or vitamin D deficiency alone, or, alternatively, whether any association exists after adjustment for important confounders.…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D status modifies the association between statin use and musculoskeletal pain: A population based study

Buettner¹,

Morioka²,

Lee³

et al. 2015

Atherosclerosis

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Background-Past studies examining the effect of vitamin D on statin myalgia have been variable; however, these studies were done in limited samples not representative of the general population. We aimed to evaluate whether vitamin D status modifies the association between statin use and musculoskeletal pain in a sample representative of the general population. Results-Among 5907 participants ≥40 years old, mean serum 25(OH)D was 23.6 ng/mL (95% CI, 22.9-24.3). In stratified multivariable-adjusted logistic regression models, individuals with 25(OH)D <15 ng/mL, using a statin had a significantly higher odds of musculoskeletal pain compared to those not using a statin (adjusted odds ratio [aOR], 1.90; 95% CI, 1.18-3.05). Among those with 25(OH)D ≥15 ng/mL, we found no significant association between statin use and musculoskeletal pain (aOR, 0.91; 95% CI, 0.71-1.16). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Methods-We DisclosuresThe authors' affiliated organizations and funding sources had no involvement in the study design; collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the article for publication. Dr. Buettner and Beth Israel Deaconess Medical Center have applied for a patent for the combination of statin and vitamin D as a prophylactic treatment in migraine. All other authors have no indicated no finanical conflicts of interests. NIH Public Access

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vitamin D status modifies the association between statin use and musculoskeletal pain: A population based study

Buettner¹,

Morioka²,

Lee³

et al. 2015

Atherosclerosis

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“…[17][18][19] Recently, several studies have assessed whether lower circulating levels of serum 25(OH)D are associated with increased risk of statin-associated myalgias. [20][21][22] While two studies did find such…”

Section: Introductionmentioning

confidence: 98%

The role of vitamin D and SLCO1B1 gene polymorphism in statin-associated myalgias

Linde

Peng

Desai

et al. 2010

Dermato-Endocrinology

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Statin-Associated Muscle Symptoms Among New Statin Users Randomly Assigned to Vitamin D or Placebo

et al. 2023

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ImportanceStatin-associated muscle symptoms (SAMS) are common and may lead to discontinuation of indicated statin therapy. Observational studies suggest that vitamin D therapy is associated with reduced statin intolerance, but no randomized studies have been reported.ObjectiveTo test whether vitamin D supplementation was associated with prevention of SAMS and a reduction of statin discontinuation.Design, Setting, and ParticipantsMen 50 years or older and women 55 years or older, free of cancer and cardiovascular disease, were enrolled in a randomized, placebo-controlled, double-blind clinical trial of vitamin D supplementation. Participants who initiated statin therapy after randomization were surveyed in early 2016. The data were analyzed in early 2022.InterventionsDaily cholecalciferol (2000 international units) or placebo with assessment of statin prescriptions during follow-up.Main Outcomes and MeasuresMuscle pain or discomfort lasting several days (primary outcome) and discontinuation of a statin due to SAMS (secondary outcome).ResultsStatins were initiated by 1033 vitamin D–assigned participants and 1050 placebo-assigned participants; mean (SD) age was 66.8 (6.2) years and 49% were women. Over 4.8 years of follow-up, SAMS were reported by 317 participants (31%) assigned vitamin D and 325 assigned placebo (31%). The adjusted odds ratio (OR) was 0.97 (95% CI, 0.80-1.18; P = .78). Statins were discontinued by 137 participants (13%) assigned to vitamin D and 133 assigned to placebo (13%) with an adjusted OR of 1.04 (95% CI, 0.80-1.35; P = .78). These results were consistent across pretreatment 25-hydroxy vitamin D levels (interaction P value = .83). Among participants with levels less than 20 ng/mL, SAMS were reported by 28 of 85 vitamin D–assigned participants (33%) and 33 of 95 placebo-assigned participants (35%). For those with levels less than 30 ng/ml, SAMS were reported by 88 of 330 vitamin–D assigned participants (27%) and 96 of 323 of placebo-assigned participants (30%).Conclusions and RelevanceVitamin D supplementation did not prevent SAMS or reduce statin discontinuation. These results were consistent across pretreatment 25-hydroxy vitamin D levels.Trial RegistrationClinicalTrials.gov Identifier: NCT01169259

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Low serum 25 (OH) vitamin D levels (<32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients

Cited by 170 publications

References 25 publications

Vitamin D status modifies the association between statin use and musculoskeletal pain: A population based study

Vitamin D status modifies the association between statin use and musculoskeletal pain: A population based study

The role of vitamin D and SLCO1B1 gene polymorphism in statin-associated myalgias

Statin-Associated Muscle Symptoms Among New Statin Users Randomly Assigned to Vitamin D or Placebo

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