Re: Statins and side effects......Statins & Lupus-like symptoms


"listener" <listener@xxxxxxxxxx> wrote in message
news:Xns976227371282some1outthere@xxxxxxxxxxxxxxxxxx
You're a chronic cherry picker

Which of these studies do you consider to be cherries?



LUPUS-LIKE SYMPTOMS AND STATINS
Frequently Asked Question: Can statins cause Lupus symptoms?


Drug-induced lupus-like syndrome associated with severe autoimmune
hepatitis.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12765306&dopt=Abstract

Graziadei IW, Obermoser GE, Sepp NT, Erhart KH, Vogel W.

Lupus. 2003;12(5):409-12.

PMID: 12765306 [PubMed - in process]

"Atorvastatin and other members of the statin family are widely used for the
treatment of hypercholesterolaemia in order to reduce the risk of
atherosclerosis and cardiovascular disease. Atorvastatin-induced adverse
events are mostly mild and only a few cases of lupus-like syndrome or severe
acute hepatitis have been documented. In this case report we describe a
patient who developed an atorvastatin-induced severe autoimmune hepatitis.
In addition, this patient presented with a concomitant systemic lupus-like
syndrome which has been already described for statins but not in association
with severe liver disease. Although the drug was immediately withdrawn the
disease persisted and even deteriorated to a fulminant disease with evidence
of acute hepatic failure. The patient failed to respond to conventional
immunosuppression with corticosteroids and azathioprine. Only the
introduction of intense immunosuppressive therapy, as used in solid organ
transplantation, led to a complete and sustained recovery of the patient.
Interestingly, the patient was HLA DR3- and HLA DR4-positive, which are
well-known genetic factors associated with autoimmune diseases. This case is
the first report of a drug-induced lupus-likesyndrome concomitant with a
severe autoimmune hepatitis in a genetically predisposed patient."



Noel B, Panizzon RG.

Lupus-like syndrome associated with statin therapy.

Dermatology. 2004;208(3):276-7.

PMID: 15118389 [PubMed - indexed for MEDLINE]

"Statins are among the most widely prescribed drugs. An increasing number of
lupus-like syndrome has recently been reported with these lipid-lowering
agents. We describe a new case associated with simvastatin therapy. The
presence of anti-dsDNA antibodies in the serum is for the first time
reported confirming that statins may also induce a systemic autoimmune
reaction. Statin-induced lupus-like syndrome is characterized by the long
delay between the beginning of therapy and the skin eruption. Antinuclear
antibodies may persist for many months after drug discontinuation. The
causal relationship may be therefore difficult to establish, and probably
many cases are unrecognized. Early diagnosis may avoid unnecessary
immunosuppressive therapy. Copyright 2004 S. Karger AG, Basel"



Lantuejoul S, Brambilla E, Brambilla C, Devouassoux G.

Statin-induced fibrotic nonspecific interstitial pneumonia.

Eur Respir J. 2002 Mar;19(3):577-80.

PMID: 11936540 [PubMed - indexed for MEDLINE]

"Statins inhibit the 3-hydroxy-3-methylglutaryl coenzyme A reductase, reduce
the serum level of low-density lipoprotein cholesterol, and are extensively
prescribed to prevent cardiovascular mortality and morbidity. Few systemic
adverse effects, such as pseudopolymyositis, lupus-like syndromes, and
anecdotal hypersensitivity pneumonitis, have been reported. A
simvastatin-induced diffuse interstitial pneumonia associated with a
nonspecific interstitial pneumonia pattern at histological analysis is
repoted here. Ultrastructural analysis showed a diffuse cytoplasmic
accumulation of intralysosomial lamellar inclusions in type II
pneumonocytes, histiocytes and endothelial cells, suggesting a shared
pathogenesis with amphiphilic drug-induced toxic lung injury. Because
statins are increasingly prescribed, statin-induced interstitial lung
disorders may be more frequently observed and early recognition will be
required."



Chazerain P, Hayem G, Hamza S, Best C, Ziza JM.

Four cases of tendinopathy in patients on statin therapy.

Joint Bone Spine. 2001 Oct;68(5):430-3.

PMID: 11707010 [PubMed - indexed for MEDLINE]

"During the last decade, statins have been widely prescribed as
lipid-lowering drugs. Their overall safety profile is good. The main
musculoskeletal side effects have consisted of muscle pain and weakness,
peripheral neuropathy, and a few cases of drug-induced lupus. We report the
first four cases of tendinopathy in patients receiving statin therapy. There
were three men and one woman. The diagnoses were extensortenosynovitis at
the hands (case 1), tenosynovitis of the tibialis anterior tendon (case 2),
and Achilles tendinopathy (cases 3 and 4). Two patients were on simvastatin
and two on atorvastatin. The tendinopathy developed 1 to 2 months after
treatment initiation. The outcome was consistently favorable within 1 to 2
months after discontinuation of the drug. Similar cases have been reported
to French pharmacovigilance centers. This report of four cases of
tendinopathy draws attention to a possible and heretofore unrecognized side
effect of a drug class that is becoming increasingly popular. Statins are
effective in lowering high cholesterol levels in patients with type IIa or
IIb hypercholesterolemia. They have been widely used for the last decade,
particularly in the secondary and primary prevention of major coronary
events. Statins act by inhibiting the enzyme
hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. Although most
patients tolerate statins extremely well, a few experience side effects
requiring treatment discontinuation. Reported musculoskeletal side effects
include myalgia and a few cases of rhabdomyolysis and polymyositis. Induced
lupus and peripheral neuropathy are exceedingly rare."




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