| ORIGINAL ARTICLE |
|
| Year : 2015 | Volume
: 7
| Issue : 3 | Page : 86-93 |
|
|
Statin intolerance because of myalgia, myositis, myopathy, or myonecrosis can in most cases be safely resolved by vitamin d supplementation
Maksim Khayznikov, Kallish Hemachrandra, Ramesh Pandit, Ashwin Kumar, Ping Wang, Charles J Glueck
Department of Internal Medicine, The Cholesterol, Metabolism and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, Ohio, USA
Correspondence Address:
Charles J Glueck
The Cholesterol, Metabolism and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, Ohio
USA
 Source of Support: Supported in part by the Lipoprotein Research
Fund of the Jewish Hospital of Cincinnati, Ohio., Conflict of Interest: None  | Check |
DOI: 10.4103/1947-2714.153919
|
|
|
Background: Low serum vitamin D can cause myalgia, myositis, myopathy, and myonecrosis. Statin-induced myalgia is a major and common cause of statin intolerance. Low serum vitamin D and statins, additively or synergistically, cause myalgia, myositis, myopathy, and/or myonecrosis. Statin-induced myalgia in vitamin D deficient patients can often be resolved by vitamin D supplementation, normalizing serum vitamin D levels. Aims: In 74 men and 72 women (age 59 ± 14 years) intolerant to ≥2 statins because of myalgia, myositis, myopathy, or myonecrosis and found to have low (<32 ng/mL) serum vitamin D, we prospectively assessed whether vitamin D supplementation (vitamin D2: 50,000-100,000 units/week) to normalize serum vitamin D would allow successful rechallenge therapy with statins. Materials and Methods: Follow-up evaluation on vitamin D supplementation was done on 134 patients at 6 months (median 5.3), 103 patients at 12 months (median 12.2), and 82 patients at 24 months (median 24). Results: Median entry serum vitamin D (22 ng/mL, 23 ng/mL, and 23 ng/mL) rose at 6 months, 12 months, and 24 months follow-up to 53 ng/mL, 53 ng/mL, and 55 ng/mL, respectively, (P < .0001 for all) on vitamin D therapy (50,000-100,000 units/week). On vitamin D supplementation, serum vitamin D normalized at 6 months, 12 months, and 24 months follow-up in 90%, 86%, and 91% of the patients, respectively. On rechallenge with statins while on vitamin D supplementation, median low-density lipoprotein cholesterol (LDLC) fell from the study entry (167 mg/dL, 164 mg/dL, and 158 mg/dL) to 90 mg/dL, 91 mg/dL, and 84 mg/dL, respectively, (P < .0001 for all). On follow-up at median 6 months, 12 months, and 24 months on statins and vitamin D, 88%, 91%, and 95% of the previously statin-intolerant patients, respectively, were free of myalgia, myositis, myopathy, and/or myonecrosis. Conclusions: Statin intolerance because of myalgia, myositis, myopathy, or myonecrosis associated with low serum vitamin D can be safely resolved by vitamin D supplementation (50,000-100,000 units /week) in most cases (88-95%). |
|
|
|
| [FULL TEXT] [PDF]* |
|
 |
|
|
|
| Article Access Statistics | | | Viewed | 9439 | | | Printed | 205 | | | Emailed | 3 | | | PDF Downloaded | 1528 | | | Comments | [Add] | | | Cited by others | 71 | | |
|
|
