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Statin‐induced Myotoxicity: Update on Case Characteristics and Recruitment Efficiency in a Clinical Practice‐based Setting
Author(s) -
Mareedu Ravi K,
Modhia Falgun M,
Krauss Ronald M,
McCarty Catherine A,
Wilke Russell A
Publication year - 2008
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.22.1_supplement.1135.5
Subject(s) - medicine , atorvastatin , statin , pravastatin , simvastatin , physical therapy , concomitant , medical record , retrospective cohort study , specialty , cholesterol , family medicine
Objectives: To characterize the clinical characteristics of the 181 research subjects participating in a retrospective case‐control study of the genetic factors underlying statin‐induced myotoxicity. Methods: Medical records of approximately 2,000,000 unique patients in a multi‐specialty group practice were interrogated electronically to identify individuals who had a serum creatinine kinase (CK) level drawn and at least one clinical note with text mentioning either atorvastatin, or, simvastatin, or, pravastatin, This yielded approximately 27,450 unique subject records. Inclusion of the upper 10th percentile for CK level (>370 IU/dL) resulted in 2745 patients. Eligibility was determined by prior physician notes reflecting an increased index of suspicion for drug intolerance. Results: Of 248 patients who met inclusion criteria, 181 subjects have chosen to enroll in the study. During physician review of these 181 cases (80 atorvastatin, 42 pravastatin, and 59 simvastatin), the clinical pain syndrome was graded using binary variables: 85/181 had diffuse pain, 52/181 had proximal pain and 36/181 had severe pain. 29/181 claimed recent vigorous physical exertion, and 20/181 reported the concomitant gemfibrozil use. Conclusions: A large subset of the validated cases had either proximal pain, diffuse pain, or severe pain. (Funding U01HL069757‐06)