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Statins and the Risk of Polyneuropathy

Statins and Risk of Polyneuropathy: A Case-control Study, by D. Gaist, MD, PhD; U. Jeppesen, MD, PhD; M. Andersen, MD, PhD; L. A. Garcia Rodriguez, MD, MSc; J. Hallas, MD, PhD; and S. H. Sindrup MD, PhD; Neurology, May 2002.

Definition

Polyneuropathy A disorder that involves the slow progressive (or recurrent) inflammation of multiple nerves. Loss of movement and sensation are common findings. Some symptoms that may be associated with this disease include:

Idiopathic polyneuopathy means that the illness has no known cause.

Background

Here is the important background information that the authors give us:

Purpose of This Study

The authors undertook this study to identify the relative risk of the occurrence of idiopathic polyneuropathy in a large population of patients taking statins.

Participants and Methodology

The authors used a patient data base from the Funen County hospital registry in Denmark. The patient registry contained information on all outpatient visits, discharges, diagnoses, and prescribed medications from nonpsychiatric hospitals in Funen County. Using that data base, the authors identified all of the patients diagnosed with idiopathic neuropathy in the 5-year period from 1994 to 1998 and. A total of 585 patients were found to meet the study criteria of:

For each patient-participant, the authors randomly selected 25 persons from the general population as "controls." The authors then performed statistical analyses to determine the links between statin use and polyneuropathy.

Results

Here is what the authors found:

Authorís Summary and Conclusions

The authors note that their study showed that long-term exposure to statins may substantially increase the risk of polyneuropathy. These findings suggest that statins may have a toxic effect on peripheral nerves. One possible mechanism may be that by interfering with cholesterol synthesis, statins may alter nerve membrane function.

Despite their findings, however, the authors remind us that statins also have known benefits in protecting against coronary artery disease. In fact, the authors tell us that "the substantial protective effect of statins, particularly on coronary artery disease, is well documented and by far outweighs the potential risk of statin-induced polyneuropathy." Nevertheless, they urge physicians who treat their patients with statins to prevent coronary artery disease to initiate a thorough workup for those patients who have complaints compatible with peripheral neuropathy. In patients who develop neuropathy, the authors recommend considering termination of the use of statins.

CHS Asks: What Should You Do With This Study?

Currently, patients who use statins are told to alert their physicians if they experience muscle pain or muscle cramps or weakness since these symptoms may indicate statin-induced myopathy (a disease of the muscles, which can be progressive, severely disabling, life-threatening, or fatal). This study shows that the risk of statin-induced polyneuropathy is higher than the risk of statin-induced myopathy.

The authorsí findings suggest that patients taking statins should alert their physicians if they experience any of the symptoms of polyneuropathy listed at the beginning of this report.

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