title: Myopathy in older people receiving statin therapy: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of the present study was to determine the risk of myopathy in older people receiving statin therapy.
  
  
  METHODS
  Eligible studies were identified searching Ovid Medline, EMBASE, Scopus, CINAHL, Cochrane and PSYCHINFO databases (1987 to July 2014). The selection criteria comprised randomized controlled studies that compared the effects of statin monotherapy and placebo on muscle adverse events in the older adult (65+ years). Data were extracted and assessed for validity by the authors. Odds ratios and 95% confidence intervals (CIs) were used to calculate binary outcomes. Evidence from included studies were pooled in a meta-analysis using Revman 5.3.
  
  
  RESULTS
  The trials assessed in the systematic review showed little or no evidence of a difference in risks between treatment and placebo groups, with myalgia [odds ratio (OR) 1.03, 95% CI 0.90, 1.17; I(2) = 0%; P = 0.66] and combined muscle adverse events (OR 1.03, 95% CI 0.91, 1.18; I(2) = 0%; P = 0.61) (myopathy). No evidence was found for an increased risk of rhabdomyolysis (OR 2.93, 95% CI 0.30, 28.18; I(2) = 0%; P = 0.35) in the seven trials that reported this. No trials reported mortality due to a muscle-related event. Discontinuations due to an adverse effect were reduced in the treatment group compared with placebo (OR 0.74, 95% CI 0.50, 1.09; I(2) = 0%; P = 0.13).
  
  
  CONCLUSIONS
  The results obtained from the present review suggest that statins are relatively safe, even in older people. There was no evidence to suggest an increased risk of myopathy in older adults receiving statin therapy. There is slightly increased seen with rhabdomyolysis when compared with the general population, although the event is relatively rare. Statins should be prescribed to elderly people who need it, and not withheld, as its myopathy safety profile is tolerable.
authors.affiliation: Institute of Primary Care and Public Health, Cardiff University School of Medicine, Neuadd Meirionnydd, University Hospital Wales, Heath Park, Cardiff, CF14 4YS, UK.
authors.forename: Roli B
authors.initials: RB
authors.lastname: Iwere
authors.affiliation: Department of Geriatric Medicine, Cardiff University School of Medicine, 3rd Floor Academic Centre, Llandough Hospital, Penlan Road, Penarth, Cardiff, Wales, CF64 2XX, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hewitt
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D016208:Databases, Factual; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D012306:Risk
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: adverse effects; aged; elderly; myalgia; myopathy; statin