The Musculoskeletal Matters of Statin Use

Statins linked to musculoskeletal diseases and injury

(RxWiki News) Statins are medications that can lower cholesterol and reduce the risk for heart disease. While these medications can be highly beneficial for many people, they can also lead to some nasty side effects.

Results of a recent study showed that musculoskeletal diseases, injuries and pain, as well as joint diseases, were more common in people who were taking statins than in those who were not.

According to the researchers, these findings raise concern in light of calls in recent years to start statin therapy at an earlier age to prevent heart disease.

"Ask a pharmacist about the risks of your statin therapy."

Ishak Mansi, MD, of the VA North Texas Health Care System, and colleagues conducted this study to see if statin use was linked with musculoskeletal conditions, including joint diseases and injury.

Based on their medication fills, more than 46,000 individuals in a military healthcare system were divided into two groups: statin users, or those who had received a statin for at least 90 days, and nonusers, or those who did not receive a statin throughout the study period during the 2005 fiscal year.

The researchers identified musculoskeletal conditions using criteria from the International Classification of Diseases, Ninth Revision, Clinical Modification.

Of the total 46,249 patients, the researchers propensity score-matched a subgroup of statin users with a subgroup of nonusers. Propensity score matching is a statistical method used to match groups of patients with similar characteristics. Using this method, the researchers matched 6,967 statin users with the same number of nonusers with similar characteristics at the beginning of the study.

Results of the propensity score-matched analysis showed that, compared to nonusers, statin users had 1.19 times higher odds of developing any musculoskeletal disease and 1.13 times higher odds of musculoskeletal injuries including dislocations, strains and sprains.

Statin users also had slightly higher odds for musculoskeletal pain compared to nonusers. 

The researchers did not find a statistically meaningful difference between the two groups when it came to the odds of developing osteoarthritis or other joint diseases.

For a second analysis, the researchers compared 6,119 statin users with no comorbidities (co-existing conditions) to 27,408 nonusers with no comorbidities.

This second analysis showed higher odds for all outcomes among statin users. Compared to nonusers, statin users had:

  • 1.12 times the odds of developing any musculoskeletal disease
  • 1.10 times the odds of developing osteoarthritis or other joint diseases
  • 1.11 times the odds of injury
  • 1.10 times the odds of musculoskeletal pain

According to the authors, this study is the first to show a link between statin use and a higher likelihood of musculoskeletal diseases, joint diseases and injury through propensity score matching.

At first, the authors wrote, they could not find a link between statin use and joint disease. They found such a link, though, in all of their other analyses.

They also noted that the study's findings "are concerning because starting statin therapy at a young age for primary prevention of cardiovascular diseases has been widely advocated."

The authors were careful to note several limitations to their study, including the use of certain measures that may not have accounted for smoking and obesity.

"In conclusion, statin use was associated with an increased likelihood of musculoskeletal condition diagnoses, including injuries and pain. Soft-tissue injuries are a less known adverse event of statins and warrant addition research," the authors wrote. "Further investigations, including randomized clinical studies and larger-scale prospective studies, particularly in physically active individuals, are necessary to obtain a more complete risk-benefit assessment for statin therapy."

The costs of statins can very widely – anywhere from $12 per month to more than $500.

This study was published June 3 in JAMA Internal Medicine.

While conducting this study, co-author Christopher R. Frei, PharmD, MSc, received support from the National Institutes of Health. Dr. Frei also disclosed receiving research grants and/or serving as a consultant or advisor for several pharmaceutical companies.

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Review Date: 
May 31, 2013