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Re: Statins: which cause least muscle pain?

Posted by sam123 on September 9, 2007, at 19:47:29

In reply to Re: Statins: which cause least muscle pain?, posted by sam123 on September 9, 2007, at 19:41:49

Crestor (Rosuvastatin) seems to be better WRT muscle pain.

http://en.wikipedia.org/wiki/Rosuvastatin

Myopathy

As with all statins, some doctors have been hesitant to prescribe rosuvastatin because of concerns that this agent might have a higher incidence of rhabdomyolysis (a severe undesired side effect) than other statins; this negative impact on sales performance has been much more pronounced in the United States than in other countries. The FDA has indicated that "it does not appear that the risk [of rhabdomyolysis] is greater with Crestor than with other marketed statins", but has mandated that a warning about this side effect, as well as a kidney toxicity warning, be added to the product label.[6] However, more recent, larger and more thorough reviews have actually demonstrated both slightly lower rates of myopathy for rosuvastatin than any of the other statins available within the United States and improved kidney function with all statin use, including rosuvastatin, see below.

Regarding myopathy and potential rhabdomyolysis, recent reviews of published data on all statins marketed in the US, and reviewed by the FDA, both pre and post-approval, have found that marked rises in the serum levels of muscle CK enzymes to 10 times normal or greater, the hallmark of serious muscle problems, remain very rare, 1:10,000 to 1:20,000 individuals. (For comparison, this incidence is about identical with that for acetaminophen, commonly purchased as Tylenol, an OTC agent about which most people rarely worry; accept as safe)

Cerivastatin was an exception; it had a higher myopathy response. For the statins still on the market in the US, reported toxicity levels has been highest for pravastatin, simvastatin next, atorvastatin next and rosuvastatin the lowest at similar milligram doses. Yet the efficacy of these agents to change blood LDLipoproteins levels, at the same milligram doses, is the exact opposite. So, from the standpoint of the rare but serious muscle toxicity events, rosuvastatin, as of mid-2005 has turned out to have the best therapeutic index of the currently available statins.


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poster:sam123 thread:781751
URL: http://www.dr-bob.org/babble/health/20070701/msgs/781887.html