title: Inhibition of xanthine oxidase to prevent statin-induced myalgia and rhabdomiolysis.
abstract: Although statins remain the cornerstone of lipid-lowering therapy for reducing the burden of atherosclerotic vascular disease, their administration has been associated with muscle-related adverse effects, including myalgia and rhabdomyolysis. Such adverse events are probably due to reduced antioxidant defenses associated with fewer intermediate metabolites in the cholesterol synthesis pathway. We hypothesize that the concomitant inhibition of xanthine oxidase via coadministration of allopurinol with statins could diminish reactive oxygen species (ROS)-related muscle damage, which would have in turn have positive effects on both the incidence of muscle-related adverse events and cardiovascular outcomes. Accordingly, inhibition of xanthine oxidase has been previously shown to be effective for reducing biomarkers of muscle damage following exercise in professional athletes. Because of the widespread statin utilization and increasing trends in their therapeutic use in atherosclerotic vascular diseases, the proposed strategy could have important clinical implications for reducing statin-induced myalgia and rhabdomyolysis.
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Alis
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; Department of Physiology, University of Valencia, Valencia, Spain; Fundación Investigación Hospital Clínico Universitario/INCLIVA, Valencia, Spain.
authors.forename: Fabian
authors.initials: F
authors.lastname: Sanchis-Gomar
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Risso-Ballester
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Carme
authors.initials: C
authors.lastname: Perez-Quilis
authors.affiliation: Department of Anesthesiology, Hospital La Fe, Valencia, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Cortell-Ballester
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; Department of Physical Education and Sports, University of Valencia, Valencia, Spain.
authors.forename: Marco
authors.initials: M
authors.lastname: Romagnoli
authors.affiliation: Research Institute "Dr. Viña Giner", Molecular and Mitochondrial Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain; School of Medicine, Catholic University of Valencia San Vicente Mártir, Valencia, Spain.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Blesa
authors.affiliation: Living Research s.a.s., Via Monte Grappa, 13, I-27038, Robbio, PV, Italy. Electronic address: enzo.emanuele@livingresearch.eu.
authors.forename: Enzo
authors.initials: E
authors.lastname: Emanuele
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000378:metabolism; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy; D063806:Myalgia / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control*; D017382:Reactive Oxygen Species; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control*; D014451:Ubiquinone / Q000378:metabolism; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
chemical_list: D015415:Biomarkers; D004791:Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017382:Reactive Oxygen Species; D014451:Ubiquinone; D000493:Allopurinol; D014969:Xanthine Oxidase
keywords: Allopurinol; Lipid-lowering drugs; Myalgia; Rhabdomyolysis; Xanthine oxidase