Roli B Iwere1, Jonathan Hewitt2. 1. Institute of Primary Care and Public Health, Cardiff University School of Medicine, Neuadd Meirionnydd, University Hospital Wales, Heath Park, Cardiff, CF14 4YS, UK. 2. Department of Geriatric Medicine, Cardiff University School of Medicine, 3rd Floor Academic Centre, Llandough Hospital, Penlan Road, Penarth, Cardiff, Wales, CF64 2XX, UK.
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). CONCLUSION: 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.
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). CONCLUSION: 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: F M Sacks; M A Pfeffer; L A Moye; J L Rouleau; J D Rutherford; T G Cole; L Brown; J W Warnica; J M Arnold; C C Wun; B R Davis; E Braunwald Journal: N Engl J Med Date: 1996-10-03 Impact factor: 91.245
Authors: Helen M Colhoun; D John Betteridge; Paul N Durrington; Graham A Hitman; H Andrew W Neil; Shona J Livingstone; Margaret J Thomason; Michael I Mackness; Valentine Charlton-Menys; John H Fuller Journal: Lancet Date: 2004 Aug 21-27 Impact factor: 79.321
Authors: J R Downs; M Clearfield; S Weis; E Whitney; D R Shapiro; P A Beere; A Langendorfer; E A Stein; W Kruyer; A M Gotto Journal: JAMA Date: 1998-05-27 Impact factor: 56.272
Authors: Hallvard Holdaas; Bengt Fellström; Alan G Jardine; Ingar Holme; Gudrun Nyberg; Per Fauchald; Carola Grönhagen-Riska; Søren Madsen; Hans-Hellmut Neumayer; Edward Cole; Bart Maes; Patrice Ambühl; Anders G Olsson; Anders Hartmann; Dag O Solbu; Terje R Pedersen Journal: Lancet Date: 2003-06-14 Impact factor: 79.321
Authors: Khoa A Nguyen; Lang Li; Deshun Lu; Aida Yazdanparast; Lei Wang; Rolf P Kreutz; Elizabeth C Whipple; Titus K Schleyer Journal: Eur J Clin Pharmacol Date: 2018-05-22 Impact factor: 2.953
Authors: Mónica González; Emilio Macias-Escalada; Juan Cobo; Maria Pilar Fernández Mondragón; Gerardo Gómez-Moreno; Marian Martínez-Martínez; Felix de Carlos Journal: Sleep Breath Date: 2016-08-25 Impact factor: 2.816
Authors: Wajd Alkabbani; Ryan Pelletier; Michael A Beazely; Youssef Labib; Breanna Quan; John-Michael Gamble Journal: Drug Saf Date: 2022-03-05 Impact factor: 5.228
Authors: Kamal Awad; Maged Mohammed; Mahmoud Mohamed Zaki; Abdelrahman I Abushouk; Gregory Y H Lip; Michael J Blaha; Carl J Lavie; Peter P Toth; J Wouter Jukema; Naveed Sattar; Maciej Banach Journal: BMC Med Date: 2021-06-22 Impact factor: 8.775