Wednesday, April 18, 2012

Report validates risk of high-dose simvastatin

More stuff on rhabdomyolysis.  Make sure you ask your doctor to explain in detail your risks and symptoms on this.
 http://www.theheart.org/article/1386379.do?utm_campaign=newsletter&utm_medium=email&utm_source=20120418_EN_Heartwire
Statins were responsible for rhabdomyolysis in 7.5% of patients diagnosed with the skeletal muscle condition, according to a review of International Classification of Disease, Ninth Edition (ICD-9) codes from a large nonprofit healthcare system in Seattle, WA.
Publishing their findings as a letter to the editor in the Journal of the American Medical Association, Dr James Floyd (University of Washington, Seattle) and colleagues also confirmed a significantly higher risk of rhabdomyolysis in patients treated with high doses of simvastatin.
Incidence rates of statin-related rhabdomyolysis

Statin Person-years of use Validated rhabdomyolysis cases, n Incidence rates per 100 000 person-years
Simvastatin <20 mg/d 21 832 0 0
Simvastatin 20-39 mg/d 75 082 4 5.3
Simvastatin 40-79 mg/d 56 703 8 14.1
Simvastatin >80 mg/d 16 876 1 64.8
All doses 170 605 23 13.5
Other statins 116 54 6 5.2
All statins 286 756 29 10.1

In total, 22 cases of statin-related rhabdomyolysis were validated among 292 statin users with an ICD-9 code for rhabdomyolysis (positive predictive value 7.5%). Seven other patients were confirmed as having statin-related rhabdomyolysis using other criteria. Overall, the risk of rhabdomyolysis was significantly elevated among patients treated with simvastatin. The incidence rate ratio (IRR) for simvastatin compared with other statins was 2.61 (95% 1.03-7.84) using all validated cases of rhabdomyolysis.
"These results confirm in a community setting findings from a recent clinical trial that prompted the US Food and Drug Administration to issue a warning about the use of high-dose simvastatin," write the researchers.

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