Statins and risk of polyneuropathy: a case-control study.
BACKGROUND
Several case reports and a single epidemiologic study indicate that use of statins occasionally may have a deleterious effect on the peripheral nervous system. The authors therefore performed a population-based study to estimate the relative risk of idiopathic polyneuropathy in users of statins.


METHODS
The authors used a population-based patient registry to identify first-time-ever cases of idiopathic polyneuropathy registered in the 5-year period 1994 to 1998. For each case, validated according to predefined criteria, 25 control subjects were randomly selected among subjects from the background population matched for age, sex, and calendar time. The authors used a prescription register to assess exposure to drugs and estimated the odds ratio of use of statins (ever and current use) in cases of idiopathic polyneuropathy compared with control subjects.


RESULTS
The authors verified a diagnosis of idiopathic polyneuropathy in 166 cases. The cases were classified as definite (35), probable (54), or possible (77). The odds ratio linking idiopathic polyneuropathy with statin use was 3.7 (95% CI 1.8 to 7.6) for all cases and 14.2 (5.3 to 38.0) for definite cases. The corresponding odds ratios in current users were 4.6 (2.1 to 10.0) for all cases and 16.1 (5.7 to 45.4) for definite cases. For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4).


CONCLUSIONS
Long-term exposure to statins may substantially increase the risk of polyneuropathy.
Gaist
D
D
Department of Neurology, Odense University Hospital, Denmark. dgaist@health.sdu.dk
Jeppesen
U
U
Andersen
M
M
García Rodríguez
L A
LA
Hallas
J
J
Sindrup
S H
SH
D000368:Aged; D016022:Case-Control Studies; D015984:Causality; D003718:Denmark / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005229:Fatty Acids, Monounsaturated / Q000009:adverse effects; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D000960:Hypolipidemic Agents / Q000009:adverse effects; D007211:Indoles / Q000009:adverse effects; D016015:Logistic Models; D008148:Lovastatin / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011115:Polyneuropathies / Q000139:chemically induced* / Q000453:epidemiology*; D017035:Pravastatin / Q000009:adverse effects; D012042:Registries; D012306:Risk; D018570:Risk Assessment; D019821:Simvastatin / Q000009:adverse effects
D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D007211:Indoles; D000077340:Fluvastatin; D008148:Lovastatin; D019821:Simvastatin; D017035:Pravastatin