Lipid-lowering drugs (statins) and peripheral neuropathy

Authors

  • Hamid Reza Farpour M.D., Physiatrist, Assistant Professor, Shiraz Geriatric Research Center, Department of Physical Medicine &Rehabilitation, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

Keywords:

Hydroxymethylglutaryl-CoA reductase inhibitors, Peripheral nervous system disease, Electrodiagnosis

Abstract

Background and aim: Peripheral neuropathy is a disorder with often unknown causes. Some drugs, including statins, are proposed to be among the causes of peripheral neuropathy. This study aimed at evaluating this condition by electrodiagnostic study among patients who had received statins. Methods: This case-control study was conducted in Shiraz, Iran in 2015, and included 39 patients aged 35-55 who had received statins for at least 6 months, and 39 healthy matched controls. Using electrodiagnosis, the sensory and motor wave features (amplitude, latency and nerve conduction velocity) of the peripheral nerves (Median, Ulnar, Tibial, Sural, and Peroneal) were evaluated among the subjects. Data were analyzed using SPSS software and p<0.05 was considered statistically significant.  Results: Regarding the occurrence of neuropathy, there were no significant differences in any of the definitions presented for peripheral neuropathy. However, the difference was close to significance for one definition [2 abnormalities in 2 nerves (p=0.055)]. Regarding mean values of the features, significant differences were observed in two features: amplitude of the peroneal motor nerve (p=0.048) and amplitude of the sural sensory nerve (p=0.036). Conclusion: Since statins are widely used, awareness regarding their side-effects would lead to better treatment. Even though no significant differences were found between the groups regarding the occurrence of peripheral neuropathy, there were significant differences in amplitudes of the sural sensory response and the peroneal motor response. This indicates the involvement of peripheral nerves. Therefore, we recommend that patients and physicians should be informed about the possible symptoms of this condition.

 

 

References

Weimer LH. Medication-induced peripheral neuropathy. Curr Neurol Neurosci Rep. 2003; 3(1): 86-92. doi:10.1007/s11910-003-0043-8. PMID: 12507417.2)Burns JM, Mauermann ML, Burns TM. An easy approach to evaluating peripheral neuropathy. J FamPractice. 2006; 55(10): 853-65. PMID: 17014750.3)Backes JM, Howard PA. Association of HMG-CoA reductase inhibitors with neuropathy. AnnPharmacother. 2003; 37(2): 274-8. doi: 10.1177/106002800303700220.4)De Langen JJ, Van Puijenbroek EP. HMG-CoA-reductase inhibitors and neuropathy: reports to theNetherlands Pharmacovigilance Centre.Neth J Med. 2006; 64(9): 334-8. PMID: 17057271.5)Donaghy M. Assessing the risk of drug-induced neurologic disorders Statins and neuropathy. Neurology.2002; 58(9): 1321-2. doi: 10.1212/WNL.58.9.1321.6)Chong PH, Boskovich A, Stevkovic N, Bartt RE. Statin‐Associated Peripheral Neuropathy: Review of theLiterature. Pharmacotherapy. 2004; 24(9): 1194-203. doi: 10.1592/phco.24.13.1194.38084.7)Corrao G, Zambon A, Bertù L, Botteri E, Leoni O, Contiero P. Lipid lowering drugs prescription and therisk of peripheral neuropathy: an exploratory case-control study using automated databases. J EpidemiolCommunity Health. 2004; 58(12): 1047-51. doi: 10.1136/jech.2003.013409.8)West B, Williams C, Jilbert E, James A, Haines T. Statin use and peripheral sensory neuropathy: a pilotstudy. J Foot Ankle Res. 2013; 6(1): 40. doi: 10.1186/1757-1146-6-S1-O40. PMCID: PMC3668969.9)Jones B, Ball G, Feher MD. Statins and peripheral neuropathy: causation or coincidence? Br J DiabetesVasc Dis. 2011; 11(1): 38-9. doi: 10.1177/1474651410394768.10)Graveline D. Adverse Effects of statin drugs: a physician patient’s perspective. J Am Phys Surg. 2015; 20:7-11.11)Pathak NN, Balaganur V, Lingaraju MC, Kant V, Latief N, More AS, et al. Atorvastatin attenuatesneuropathic pain in rat neuropathy model by down-regulating oxidative damage at peripheral, spinal andsupraspinal levels. Neurochem Int. 2014; 68: 1-9. doi: 10.1016/j.neuint.2014.01.014.12)Otruba P, Kanovsky P, Hlustic P. Treatment with statins and involvement of peripheral nervous system:results of a prospective clinical and neurophysiological follow-up. Biomed pap med fac univ palackyolomouc Czech Repub. 2007; 151: 307-10. PMID: 18345269.13)Chaitow L. Muscle pain and use of statin drugs. J Bodyw Mov Ther. 2014; 18(2): 149-50. doi:10.1016/j.jbmt.2014.02.001.14)Bosomworth NJ. Statin Therapy as Primary Prevention in Exercising Adults: Best Evidence for AvoidingMyalgia. J Am Board Fam Med. 2016; 29: 727–40. doi: 10.3122/jabfm.2016.06.160085.15)Gaist D, Jeppesen U, Andersen M, Garcia Rodrigueez LA,Hallas J, Sindrup SH. Statins and risk ofpolyneuropathy. Neurology. 2002; 58: 1333-7. doi: 10.1212/WNL.58.9.1333.16)Vaughan TB, Bell DS. Statin neuropathy masquerading as diabetic autoimmune polyneuropathy. DiabetesCare. 2005; 28(8): 2082. doi: 10.2337/diacare.28.8.2082.17)Kalra S, Agrawal N, Kalra B, Sharma A, Kamboj R. The role of Coenzyme Q10 in statin-associatedmyopathy. Electron Physician. 2009; 1: 2-8.

Dumitru D, Amato A. Approach to peripheral neuropathy. Electrodiagnostic medicine. 2nd ed.Philadelphia: Hanley & Belfus; 2002: 194-217.19)Preston DC, Shapiro BE. Electromyography and Neuromuscular Disorders, Clinical-ElectrophysiologicCorrelations. 2nd ed. Elsevier; 2005: 117-59.20)Phan T, Mclead JG, Pollard JD, Peiris O, Rohan A, J-P Halpern. Peripheral neuropathy associated withsimvastatin. J Neurol Neurosurg Psychiatry. 1995; 58: 625-8. doi: 10.1136/jnnp.58.5.625.21)Vilholm OJ, Christensen AA, Zedan AH, Itani M. Drug‐Induced Peripheral Neuropathy. Basic ClinPharmacol Toxicol. 2014; 115(2): 185-92. doi: 10.1111/bcpt.12261.22)West B. The implications of statin induced peripheral neuropathy. J Foot Ankle Res. 2011; 4(1):57. doi:10.1186/1757-1146-4-S1-P57.23)Gaist D, Huerta C, Hallas J, Sindrup S. Are users of lipid-lowering drugs at increased risk of peripheralneuropathy? Eur J Clin pharmacol. 2001; 56: 931-3. doi: 10.1007/s002280000248.24)Davis TM, Yeap BB, Davis WA, Bruce DG. Lipid-lowering therapy and peripheral sensory neuropathy intype 2 diabetes: the Fremantle Diabetes Study. Diabetologia. 2008; 51(4): 562-6. doi: 10.1007/s00125-007-0919-2.25)Menahem S, Shvartzman P. Simvastatin-induced meralgia paresthetica. J Am Board Fam Med. 2011;24(4): 469-73. doi: 10.3122/jabfm.2011.04.100229.26)Scola RH, Trentin AP, Germiniani F, Piovesan ÉJ, Werneck LC. Simvastatin-induced mononeuropathymultiplex: case report. Arq Neuropsiquiatr. 2004; 62(2B): 540-2. DOI: 10.1590/S0004-282X2004000300031.27)Ziajka PE, Wehmeier T. Peripheral neuropathy and lipid-lowering therapy. South Med J. 1998; 91(7): 667-8. doi: 10.1097/00007611-199807000-00013. PMID:9671841.28)Jeppesen U, Gaist D, Smith T, Sindrup SH. Statins and peripheral neuropathy. Eur J Clin Pharmacol. 1999;54(11): 835-8. DOI: 10.1007/s002280050562.

Published

2021-12-24

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