title: Statin-induced rhabdomyolysis: a comprehensive review of case reports.
abstract: OBJECTIVE
  To identify case reports of statin-induced rhabdomyolysis and summarize common predisposing factors, symptoms, diagnostic findings, functional outcomes, characteristics, treatment, and rehabilitation.
  
  
  METHODS
  MEDLINE, CINAHL, SCOPUS, and PEDro databases were searched (1990-2013) 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=55); the majority of cases reported the use of concomitant medications such as fibrates (n=25). Weakness (n=65) and muscle pain (n=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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Graduate Department of Rehabilitation Science.
authors.forename: Polyana
authors.initials: P
authors.lastname: Mendes
authors.affiliation: Graduate Department of Rehabilitation Science.
authors.forename: Priscila Games
authors.initials: PG
authors.lastname: Robles
authors.affiliation: Graduate Department of Rehabilitation Science ; Department of Physical Therapy, University of Toronto, Toronto.
authors.forename: Sunita
authors.initials: S
authors.lastname: Mathur
keywords: HMG-CoA; muscular diseases; rhabdomyolysis; statins