Proton Pump Inhibitors and Risk of Rhabdomyolysis

AbstractProton pump inhibitors (PPIs) have been associated with a variety of adverse events, although the level of evidence for many of these is weak at best. Recently, one national regulatory authority has mandated a change to the labeling of one PPI based on reports of possible associated rhabdomyolysis. Thus, in this review we summarize the available evidence linking PPI use with rhabdomyolysis. The level of evidence is insufficient to establish a causal relationship and is largely based on sporadic case reports. In general, patients with suspected PPI-associated rhabdomyolysis have not been re-challenged with a PPI after recovery. The mechanism whereby PPIs might have been associated with rhabdomyolysis is unclear but possibly related to interaction with concomitantly administered drugs such as HMG-CoA reductase inhibitors (statins). For patients with rhabdomyolysis, a careful search must be made for possible etiological factors. In patients who recover from an episode of possible PPI-related rhabdomyolysis but do not have a genuine requirement for PPI treatment, the PPI should not be re-introduced. For those with a definite indication for ongoing PPI treatment, the PPI can be re-introduced but should preferably not be administered with a statin.
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research

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Anaplasma phagocytophilum (AP) is the causative agent of human granulocytic anaplasmosis (HGA), a tick-borne illness with highest incidence in north-eastern regions of the United States. This condition presents with vague constitutional symptoms and has been associated with laboratory derangements such as leukopenia, thrombocytopenia and transaminitis [1]. Rhabdomyolysis, however, is not one of these associations. There has only been one prior case report in which a patient developed rhabdomyolysis-induced acute kidney injury (AKI) secondary to AP, that too in the setting of concomitant statin use [2].
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
Authors: Kim MC, Ahn Y, Cho KH, Sim DS, Hong YJ, Kim JH, Jeong MH PMID: 32153146 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
CONCLUSIONS: The LDL cholesterol, total cholesterol, and triglyceride lowering effect of cerivastatin was linearly dependent on dose. Cerivastatin log dose-response data were linear over the commonly prescribed dose range. Based on an informal comparison with fluvastatin, atorvastatin and rosuvastatin, cerivastatin was about 250-fold more potent than fluvastatin, 20-fold more potent than atorvastatin and 5.5-fold more potent than rosuvastatin in reducing LDL cholesterol, and 233-fold greater potency than fluvastatin, 18-fold greater potency than atorvastatin and six-fold greater potency than rosuvastatin at reducing total ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusions: Many patients with involutional ptosis also have both cardiovascular disease and hyperlipidemia and thus take cholesterol-lowering medication. Our study demonstrates a World Health Organization-defined probable association between ptosis and anticholesterol-induced myopathy. The frequency of anticholesterol-induced myopathy in adult ptosis was 4.4%, which is substantially higher than previously predicted. Anticholesterol-induced myositis can cause a reversible ptosis, and thus, a thorough evaluation of adult patients presenting with involutional ptosis includes inquiry into the use of anticholesterol drugs a...
Source: Ophthalmic Plastic and Reconstructive Surgery - Category: Opthalmology Tags: Original Investigations Source Type: research
AbstractStatins are currently the primary treatment for hyperlipidemia, particularly for the treatment of high levels of low-density lipoprotein cholesterol (LDL-C), as many studies have proven benefit in a variety of populations. The benefits of statin treatment for high cholesterol have been proven in many trials. Forefront among different adverse events is statin-induced myopathy, which still eludes complete understanding, and may range anywhere from muscle soreness or fatigue to potentially extremely rare occurrence of rhabdomyolysis.As most adverse events are rare and not life-threatening, in high-risk patients, a hig...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Authors: Rallidis LS Abstract Statin-associated muscle symptoms (SAMS) are the most frequent clinically relevant adverse effect of statins causing discontinuation of statin treatment and subsequent increase in cardiovascular events. The incidence of SAMS in clinical practice is 5-10%. Clinical manifestations of SAMS are highly heterogeneous and ranges from mild weakness, cramps and muscle pains to the very rare and severe rhabdomyolysis. The most common type of SAMS (>80%) is muscle pains without or with mild increase in creatine kinase. The management of patients with SAMS is a clinical challenge. A strategic a...
Source: Hellenic Journal of Cardiology - Category: Cardiology Tags: Hellenic J Cardiol Source Type: research
CONCLUSION: Evolocumab was superior to ezetimibe in reducing LDL-C during the 12-week double-blind period in this population of Japanese patients with statin intolerance, with efficacy and safety results maintained for 1 year. TRIAL REGISTRATION:, NCT02634580. PMID: 31748467 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - Category: Cardiology Tags: J Atheroscler Thromb Source Type: research
CONCLUSIONS: Statin treatment is an effective lipid-lowering therapy in children with familial hypercholesterolemia. Few or no safety issues were identified. Statin treatment seems to be safe in the short term, but long-term safety remains unknown. Children treated with statins should be carefully monitored and followed up by their pediatricians and their care transferred to an adult lipidologist once they reach 18 years of age. Large long-term randomized controlled trials are needed to establish the long-term safety issues of statins. PMID: 31696945 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Abstract Elderly patients are a special category of patients, due to the physiological changes induced by age, the great number of comorbidities and drug treatment and last, but not least, to the cognitive dysfunction frequently encountered in this population. Cardiovascular disease is the most important cause of morbidity and mortality in elderly individuals worldwide. The rate of cardiovascular events increases after 65 years in men and after 75 years in women. Myocardial infarction and stroke are the leading disorders caused by atherosclerosis, that lead to death or functional incapacity. Elderly people have a ...
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
In conclusion, this preliminary pharmacogenetic study identifies thatCOQ2 gene polymorphism (rs4693075, G  >  C), notTNF- α gene polymorphism (rs1799724, C  >  T), is involved in causing statin-induced myopathy in Bangladeshi hyperlipidemic patients.
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research
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