title: Statin induced myotoxicity.
abstract: Statins are an effective treatment for the prevention of cardiovascular diseases and used extensively worldwide. However, myotoxicity induced by statins is a common adverse event and a major barrier to maximising cardiovascular risk reduction. The clinical spectrum of statin induced myotoxicity includes asymptomatic rise in creatine kinase concentration, myalgia, myositis and rhabdomyolysis. In certain cases, the cessation of statin therapy does not result in the resolution of muscular symptoms or the normalization of creatine kinase, raising the possibility of necrotizing autoimmune myopathy. There is increasing understanding and recognition of the pathophysiology and risk factors of statin induced myotoxicity. Careful history and physical examination in conjunction with selected investigations such as creatine kinase measurement, electromyography and muscle biopsy in appropriate clinical scenario help diagnose the condition. The management of statin induced myotoxicity involves statin cessation, the use of alternative lipid lowering agents or treatment regimes, and in the case of necrotizing autoimmune myopathy, immunosuppression.
authors.affiliation: The Walton Centre NHS Foundation Trust, Lower Lane, Liverpool L9 7LJ, United Kingdom. s_sathasivam@hotmail.com
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Sathasivam
mesh_terms: D003577:Cytochrome P-450 Enzyme System / Q000502:physiology; D020022:Genetic Predisposition to Disease; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D009135:Muscular Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology; D009220:Myositis / Q000139:chemically induced / Q000503:physiopathology; D012206:Rhabdomyolysis / Q000139:chemically induced; D012307:Risk Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D003577:Cytochrome P-450 Enzyme System