Statin Adverse Effects: A Review of the Literature and Evidence for a Mitochondrial Mechanism

Beatrice A. Golomb; Marcella A. Evans

Disclosures

Am J Cardiovasc Drugs. 2008;8(6):373-418. 

In This Article

Prevention, Treatment, and Recovery of Statin AEs

Observational and limited randomized data variably suggest partial (though incomplete) benefit of coenzyme Q10 supplementation to muscle symptoms; and to other AEs of statins (observational data).[884,885,886,887] Additional studies are required to better understand the role of coenzyme Q10 supplementation in prevention and mitigation of statin AEs. It merits note that preparations of coenzyme Q10 vary widely in their bioavailability.[888]

Randomized trial evidence has little to offer in understanding recovery profiles for statin AEs, although some evidence is beginning to emerge. While one study reported uniform recovery of statin muscle AEs,[889] a larger statin myopathy clinic including more objective data noted that recovery is often incomplete when objective measures are used.[890] Other evidence supports this, noting for muscle AEs that "variable persistent symptoms occurred in 68% of patients despite cessation of therapy."[156] Incomplete resolution in some subjects has been reported for other AEs. Thus, in an analysis of data, presented in the Australian Adverse Drug Reactions Bulletin, it was noted that "Statin-associated peripheral neuropathy may persist for months or years after withdrawal of the statin… In two ADRAC (Adverse Drug Reactions Advisory Committee) cases of persistent peripheral neuropathy, motor and sensory conduction tests showed minimal recovery 4 and 12 months, respectively, after discontinuation of simvastatin, despite clinical improvement."[571]

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