Statin Induced Myotoxicity and Its Consequences - an Overview

Statins, 3-hydroxymethyl-3-methylglutaryl coenzyme A reductase inhibitors, are considered safe in lowering hyperlipidemia and cardiovascular disease. Statin attempt to reduce cholesterol production in liver in dose dependent manner not only cause the muscle related problem but also leads to other untoward consequence like arthritis, diabetes, neurological disorders which arise as a result of scarcity in cholesterol production. Discontinuation or reduction in the dose of the statin usually leads to resolution of these side effects but the efficacy is questionable. Though the statin had come to market several decades ago, their harmful effects have been well understood very recently only after several randomized trials. The pleiotropic effects of statin have reported many benefits, but lack of randomized clinical trials make it limit to extend its indication beyond lipid lowering effects. There is still a controversy between their benefits and adverse effects of statin. The upcoming research should focus to resolve the above said confliction that could overcome its most adverse eventsmyopathy. If it so the statin with pleiotropic effect without any myopathic symptoms would be an excellent candidate among all other drugs. In this review, we discussed the myotoxicity, mechanism of myopathy, consequences as a result of statin‟s attempt to reduce cholesterol production, risk factors for myopathy. INTRODUCTION: Stain, the 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMG-CO A) inhibitors, are the most prescribed and first choice class of drugs in the treatment and management of hyperlipidemia and related cardiovascular diseases (CVD). 1 These have been long-established in reducing cardiovascular morbidity and mortality in low to high risk patients. 2 From the introduction of Lovastatin in 1987 to pitavastatin of late the research has not been ruined in findings of beneficial to adverse events of statin. 3, 4 QUICK RESPONSE CODE DOI: 10.13040/IJPSR.0975-8232.7(8).3197-07 Article can be accessed online on: www.ijpsr.com DOI link: http://dx.doi.org/10.13040/IJPSR.0975-8232.7 (8).3197-07 The population reported for statin induced myopathy is significantly less in clinical trials due to restricted criteria followed but it is more in case of observational studies. 5, 6 In large clinical trials 7 the efficacy and safety of statins have been well acknowledged but after long-lasting use of these drugs in unselected population of outpatients (findings from observational studies), 8 it has been reported to have unrecognized troublesome adverse effects. 9 Various adverse events had been reported and range from mild to severe. Among these, muscle (ranges from myalgia to rhabdomyolysis) and liver toxicity are major one in which hazard increases due to higher dose, interacting drug and genetic predisposition leading to death. 10, 11 These are not covered during preclinical testing of statin, but reported during clinical studies and some other