Neurol. praxi. 2017;18(1):15-19 | DOI: 10.36290/neu.2017.058

Statin myopathy

prof. MUDr. Josef Bednařík, CSc., MUDr. Eva Vlčková, Ph.D., MUDr. Tomáš Horák

Neurologická klinika LF MU a FN Brno

Statins are competitive inhibitors of enzyme 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) lowering cholesterol and low-density

lipoprotein levels. Due to their effectiveness they became the most frequently used group of drugs worldwide taken by more than 100

millions of patients. Statin myopathy is the most frequent and serious adverse event of statin use. Its clinical spectrum is very broad fluctuating

from asymptomatic hyper-CK-aemia, myalgia, crampi, muscle weakness to most serious rhabdomyolysis with 10 % mortality. Randomized

controlled and cohort studies report statin myopathy incidence of 1–5 % and the incidence of rhabdomyolysis of 1.6–4.4 cases/per 100

thousands of cases/per year. The real incidence in the clinical setting with respect to the results of observational studies is estimated to be

10–15 %. Statin myopathy usually manifests within 6 months of statin use and myopathic symptoms are completely or partially reversible.

Newly described statin induced necrotizing autoimmune myopathy associated with autoantibodies against HMGCR displayed different

course and clinical pattern, manifesting usually after years of statin use and requiring immunomodulatory treatment. The review offers

overview of current knowledge upon pathophysiology of statin myopathy and recommendations concerning its practical management.

Keywords: statins, myopathy, rhabdomyolysis, 3-hydroxy-3-methylglutaryl coenzyme A reductase

Published: March 1, 2017  Show citation