title: Tendon rupture associated with simvastatin/ezetimibe therapy.
abstract: A case of spontaneous biceps tendon rupture in a physician during therapy with the combination of simvastatin and ezetimibe (Vytorin) is reported. Rechallenge produced tendinopathy in the contralateral biceps tendon that abated with drug discontinuation. Tendon rupture generally occurs in injured tendons. Physiological repair of an injured tendon requires degradation and remodeling of the extracellular matrix through matrix metalloproteinases (MMPs). Statins are known to inhibit MMPs. It was hypothesized that statins may increase the risk of tendon rupture by altering MMP activity. In conclusion, statins may increase the risk of tendon rupture by altering MMP activity.
authors.affiliation: Department of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA.
authors.forename: Raja C
authors.initials: RC
authors.lastname: Pullatt
authors.forename: Mamatha Reddy
authors.initials: MR
authors.lastname: Gadarla
authors.forename: Richard H
authors.initials: RH
authors.lastname: Karas
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
authors.forename: Paul D
authors.initials: PD
authors.lastname: Thompson
mesh_terms: D000924:Anticholesteremic Agents / Q000009:adverse effects*; D001384:Azetidines / Q000009:adverse effects*; D000069438:Ezetimibe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D008279:Magnetic Resonance Imaging; D008297:Male; D045726:Metalloproteases / Q000378:metabolism; D008875:Middle Aged; D019821:Simvastatin / Q000009:adverse effects*; D013708:Tendon Injuries / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D013710:Tendons / Q000187:drug effects
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin; D045726:Metalloproteases; D000069438:Ezetimibe