• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (51)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Neuromuscular diseases  • Drug Therapy  • Adverse Effects  • Alert me on articles by topic  Social Bookmarking   What's this?

Costanza Lamperti, MD; Ali B. Naini, PhD; Valeria Lucchini, MD; Alessandro Prelle, MD; Nereo Bresolin, MD; Maurizio Moggio, MD; Monica Sciacco, MD; Petra Kaufmann, MD; Salvatore DiMauro, MD

Arch Neurol. 2005;62:1709-1712.

Background  Statin drugs (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) reduce the level of cholesterol by inhibiting the synthesis of mevalonate, an intermediary in the cholesterol biosynthetic pathway. Use of statin drugs has been associated with a variety of skeletal muscle–related complaints. Coenzyme Q₁₀ (CoQ₁₀), a component of the mitochondrial respiratory chain, is also synthesized from mevalonate, and decreased muscle CoQ₁₀ concentration may have a role in the pathogenesis of statin drug–related myopathy.

Objectives  To measure the CoQ₁₀ concentration and respiratory chain enzyme activities in muscle biopsy specimens from 18 patients with statin drug–related myopathy and to look for evidence of apoptosis using the TUNEL (terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate nick-end labeling) assay.

Design  An open-labeled study of CoQ₁₀ concentration in muscle from patients with increased serum creatine kinase concentrations while receiving standard statin drug therapy.

Setting  Neuromuscular centers at 2 academic tertiary care hospitals.

Results  Muscle structure was essentially normal in 14 patients and showed evidence of mitochondrial dysfunction and nonspecific myopathic changes in 2 patients each. Muscle CoQ₁₀ concentration was not statistically different between patients and control subjects, but it was more than 2 SDs below the normal mean in 3 patients and more than 1 SD below normal in 7 patients. There was no TUNEL positivity in any patients.

Conclusion  These data suggest that statin drug–related myopathy is associated with a mild decrease in muscle CoQ₁₀ concentration, which does not cause histochemical or biochemical evidence of mitochondrial myopathy or morphologic evidence of apoptosis in most patients.

Author Affiliations: Centro Dino Ferrari, Dipartimento di Scienze Neurologiche, Unita’ Operativa, Neurologia, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Maggiore Policlinico, University of Milan, Milan, Italy (Drs Lamperti, Lucchini, Prelle, Bresolin, Moggio, and Sciacco); and Department of Neurology, Columbia University Medical Center, New York, NY (Drs Naini, Kaufmann, and DiMauro).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Strategies to preserve the use of statins in patients with previous muscular adverse effects
Reinhart and Woods
Am J Health Syst Pharm 2012;69:291-300.
ABSTRACT | FULL TEXT  

Coenzyme Q10: A therapy for hypertension and statin-induced myalgia?
WYMAN et al.
Cleveland Clinic Journal of Medicine 2010;77:435-442.
ABSTRACT | FULL TEXT  

Approach to the Patient Who Is Intolerant of Statin Therapy
Eckel
J. Clin. Endocrinol. Metab. 2010;95:2015-2022.
ABSTRACT | FULL TEXT  

Human Skeletal Muscle Drug Transporters Determine Local Exposure and Toxicity of Statins
Knauer et al.
Circ. Res. 2010;106:297-306.
ABSTRACT | FULL TEXT  

Statin-induced muscle damage and atrogin-1 induction is the result of a geranylgeranylation defect
Cao et al.
FASEB J. 2009;23:2844-2854.
ABSTRACT | FULL TEXT  

The interactions of some commonly consumed drugs with mitochondrial adaptations to exercise
Robinson et al.
J. Appl. Physiol. 2009;107:8-16.
ABSTRACT | FULL TEXT  

Narrative Review: Statin-Related Myopathy
Joy and Hegele
ANN INTERN MED 2009;150:858-868.
ABSTRACT | FULL TEXT  

The Role of Coenzyme Q10 in Statin-Associated Myopathy: A Systematic Review
Marcoff and Thompson
J Am Coll Cardiol 2007;49:2231-2237.
ABSTRACT | FULL TEXT  

Which statin, what dose?
DTB 2007;45:33-37.
ABSTRACT | FULL TEXT  

Considerations for Supplementing with Coenzyme Q10 During Statin Therapy
Levy and Kohlhaas
The Annals of Pharmacotherapy 2006;40:290-294.
ABSTRACT | FULL TEXT