Statin-Induced Rhabdomyolysis: A Comprehensive Review of Case Reports

Abstract

Purpose: To identify case reports of statin-induced rhabdomyolysis and summarize common predisposing factors, symptoms, diagnostic findings, functional outcomes, characteristics, treatment, and rehabilitation. Method: MEDLINE, CINAHL, SCOPUS, and PEDro databases were searched for relevant case reports using the search terms ''Statins,'' ''Rhabdomyolysis,'' ''Myalgia,'' ''Muscle damage,'' ''Muscle injury,'' and ''Myopathy.'' Relevance (based on title and abstract) was assessed by one investigator; two investigators independently reviewed the relevant articles to determine inclusion in the review. Results: A total of 112 cases met the inclusion criteria. The majority were in men (70%) and people over 45 years of age (mean 64 [SD 14] years). Simvastatin was the most commonly reported statin (n ¼ 55); the majority of cases reported the use of concomitant medications such as fibrates (n ¼ 25). Weakness (n ¼ 65) and muscle pain (n ¼ 64) were the most common symptoms. In 19 cases, the patient was referred to rehabilitation, but the case reports do not include descriptions of the treatment. Conclusion: Statin-induced rhabdomyolysis was more commonly reported when statins were used in conjunction with other drugs, which potentiated its effect. Research is needed to identify the role of exercise and rehabilitation following statin-induced rhabdomyoloysis since muscle damage may be severe and may have long-term effects on muscle function.Key Words: HMG-CoA; muscular diseases; rhabdomyolysis; statins. RÉ SUMÉObjectif : Trouver des rapports de cas portant sur la rhabdomyolyse provoqué e par les statines et ré sumer les facteurs pré disposants communs, les symptô mes, les ré sultats diagnostiques, les ré sultats fonctionnels, les caracté ristiques, le traitement et la ré adaptation. Mé thodes : On a cherché dans les bases de donné es MEDLINE, CINAHL, SCOPUS et PEDro (1990PEDro ( -2013 des rapports de cas pertinents en utilisant les termes de recherche Statins, Rhabdomyolysis, Myalgia, Muscle damage, Muscle injury et Myopathy. Un chercheur en a é valué la pertinence (en fonction du titre et du ré sumé ) et deux autres ont revu indé pendamment les articles pertinents pour dé terminer s'il fallait les inclure dans la recherche. Ré sultats : Au total, 112 cas ré pondaient aux critè res d'inclusion. La majorité des cas portaient sur des hommes (70 %) et les plus de 45 ans (â ge moyen de 64 [ET 14] ans). La simvastatine a é té la statine incriminé e le plus souvent dans les rapports (n ¼ 55), la majorité des cas signalant l'utilisation simultané e de mé dicaments comme des fibrates (n ¼ 25). La faiblesse (n ¼ 65) et les douleurs musculaires (n ¼ 64) é taient les symptô mes les plus courants. Dans 19 cas, le patient a é té aiguillé vers la ré adaptation, mais les rapports ne dé crivent pas le traitement. Conclusion : On a signalé une rhabdomyolyse causé e par les statines plus souvent lorsqu'elles é taient conjugué es à d'autres mé dicaments, ce qui en a accentué l'effet. Des recherches s'imposent pour dé terminer le rô le ...

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Coenzyme Q10 supplementation: Efficacy, safety, and formulation challenges

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