Worsening of myasthenic symptoms associated with statins
The common presentations of statin intolerance are muscle-specific symptoms. Although statins are one type of drug reported to cause myasthenic worsening, myasthenic worsening has not been recognized as statin intolerance. The purpose of the present study is to investigate in a large cohort the safe...
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| Veröffentlicht in: | Journal of the neurological sciences 2024-09, Vol.464, p.123154, Article 123154 |
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| creator | Sugimoto, Takamichi Suzuki, Shigeaki Uzawa, Akiyuki Yamawaki, Takemori Masuda, Masayuki Minami, Naoya Kawaguchi, Naoki Kubota, Tomoya Takahashi, Masanori P. Suzuki, Yasushi Watanabe, Genya Konno, Shingo Kimura, Takashi Samukawa, Makoto Ishizuchi, Kei Akamine, Hiroyuki Onishi, Yosuke Yasuda, Manato Nagane, Yuriko Maruyama, Hirofumi Murai, Hiroyuki Utsugisawa, Kimiaki |
| description | The common presentations of statin intolerance are muscle-specific symptoms. Although statins are one type of drug reported to cause myasthenic worsening, myasthenic worsening has not been recognized as statin intolerance. The purpose of the present study is to investigate in a large cohort the safety profiles of statins in patients with myasthenia gravis (MG).
A total of 1710 consecutive patients with MG who visited sites associated with the Japan MG registry 2021 group between April and October 2021 were reviewed. Statin-associated myasthenic worsening was defined as worsening of any myasthenic symptoms on statin use and improvement of the symptom by stopping the statin or by undertaking additional treatment with patient and doctor confirmation.
Among the 400 patients who used statins, 8 (2%) patients experienced statin intolerance and 6 (1.5%) patients experienced myasthenic worsening. No patients developed MG on the statin. Ptosis was a main symptom of myasthenic worsening in 4 (67%) patients. Atorvastatin was used in all patients with statin-associated myasthenic worsening. The symptoms of statin intolerance and statin-associated myasthenic worsening were improved within 2 months and 3 months, respectively, in all patients by cessation of statin use.
Regarding statin-associated myasthenic worsening, prevalence was low, and severity was mild; with cessation of statin use, symptoms improved within a few months, and outcomes were generally good. Although statins can be used in MG patients with little concern, statin-associated myasthenic worsening should be noted in addition to the classical statin intolerance associated with statin use.
•In 1710 MG patients, 400 patients used statins and 2% experienced statin intolerance.•1.5% had statin-associated myasthenic worsening and ptosis was a primary symptom.•Symptoms improved within only a few months with cessation of statin use.•Statins should be used and monitored in MG patients if needed.•Statin-associated myasthenic worsening should be added in classical statin intolerance. |
| doi_str_mv | 10.1016/j.jns.2024.123154 |
| format | Article |
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A total of 1710 consecutive patients with MG who visited sites associated with the Japan MG registry 2021 group between April and October 2021 were reviewed. Statin-associated myasthenic worsening was defined as worsening of any myasthenic symptoms on statin use and improvement of the symptom by stopping the statin or by undertaking additional treatment with patient and doctor confirmation.
Among the 400 patients who used statins, 8 (2%) patients experienced statin intolerance and 6 (1.5%) patients experienced myasthenic worsening. No patients developed MG on the statin. Ptosis was a main symptom of myasthenic worsening in 4 (67%) patients. Atorvastatin was used in all patients with statin-associated myasthenic worsening. The symptoms of statin intolerance and statin-associated myasthenic worsening were improved within 2 months and 3 months, respectively, in all patients by cessation of statin use.
Regarding statin-associated myasthenic worsening, prevalence was low, and severity was mild; with cessation of statin use, symptoms improved within a few months, and outcomes were generally good. Although statins can be used in MG patients with little concern, statin-associated myasthenic worsening should be noted in addition to the classical statin intolerance associated with statin use.
•In 1710 MG patients, 400 patients used statins and 2% experienced statin intolerance.•1.5% had statin-associated myasthenic worsening and ptosis was a primary symptom.•Symptoms improved within only a few months with cessation of statin use.•Statins should be used and monitored in MG patients if needed.•Statin-associated myasthenic worsening should be added in classical statin intolerance.</description><identifier>ISSN: 0022-510X</identifier><identifier>ISSN: 1878-5883</identifier><identifier>EISSN: 1878-5883</identifier><identifier>DOI: 10.1016/j.jns.2024.123154</identifier><identifier>PMID: 39142082</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Acetylcholine receptor ; Adult ; Aged ; Aged, 80 and over ; Atorvastatin - adverse effects ; Atorvastatin - therapeutic use ; Cohort Studies ; Disease Progression ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Japan - epidemiology ; Male ; Middle Aged ; Myasthenia gravis ; Myasthenia Gravis - chemically induced ; Myasthenia Gravis - drug therapy ; Neuromuscular junction ; Registries ; Statin intolerance ; Unmasking</subject><ispartof>Journal of the neurological sciences, 2024-09, Vol.464, p.123154, Article 123154</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c235t-a0661efed02544a119a4da1a1862697978c1841c5c381eb6e59980bb712f77853</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jns.2024.123154$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39142082$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sugimoto, Takamichi</creatorcontrib><creatorcontrib>Suzuki, Shigeaki</creatorcontrib><creatorcontrib>Uzawa, Akiyuki</creatorcontrib><creatorcontrib>Yamawaki, Takemori</creatorcontrib><creatorcontrib>Masuda, Masayuki</creatorcontrib><creatorcontrib>Minami, Naoya</creatorcontrib><creatorcontrib>Kawaguchi, Naoki</creatorcontrib><creatorcontrib>Kubota, Tomoya</creatorcontrib><creatorcontrib>Takahashi, Masanori P.</creatorcontrib><creatorcontrib>Suzuki, Yasushi</creatorcontrib><creatorcontrib>Watanabe, Genya</creatorcontrib><creatorcontrib>Konno, Shingo</creatorcontrib><creatorcontrib>Kimura, Takashi</creatorcontrib><creatorcontrib>Samukawa, Makoto</creatorcontrib><creatorcontrib>Ishizuchi, Kei</creatorcontrib><creatorcontrib>Akamine, Hiroyuki</creatorcontrib><creatorcontrib>Onishi, Yosuke</creatorcontrib><creatorcontrib>Yasuda, Manato</creatorcontrib><creatorcontrib>Nagane, Yuriko</creatorcontrib><creatorcontrib>Maruyama, Hirofumi</creatorcontrib><creatorcontrib>Murai, Hiroyuki</creatorcontrib><creatorcontrib>Utsugisawa, Kimiaki</creatorcontrib><title>Worsening of myasthenic symptoms associated with statins</title><title>Journal of the neurological sciences</title><addtitle>J Neurol Sci</addtitle><description>The common presentations of statin intolerance are muscle-specific symptoms. Although statins are one type of drug reported to cause myasthenic worsening, myasthenic worsening has not been recognized as statin intolerance. The purpose of the present study is to investigate in a large cohort the safety profiles of statins in patients with myasthenia gravis (MG).
A total of 1710 consecutive patients with MG who visited sites associated with the Japan MG registry 2021 group between April and October 2021 were reviewed. Statin-associated myasthenic worsening was defined as worsening of any myasthenic symptoms on statin use and improvement of the symptom by stopping the statin or by undertaking additional treatment with patient and doctor confirmation.
Among the 400 patients who used statins, 8 (2%) patients experienced statin intolerance and 6 (1.5%) patients experienced myasthenic worsening. No patients developed MG on the statin. Ptosis was a main symptom of myasthenic worsening in 4 (67%) patients. Atorvastatin was used in all patients with statin-associated myasthenic worsening. The symptoms of statin intolerance and statin-associated myasthenic worsening were improved within 2 months and 3 months, respectively, in all patients by cessation of statin use.
Regarding statin-associated myasthenic worsening, prevalence was low, and severity was mild; with cessation of statin use, symptoms improved within a few months, and outcomes were generally good. Although statins can be used in MG patients with little concern, statin-associated myasthenic worsening should be noted in addition to the classical statin intolerance associated with statin use.
•In 1710 MG patients, 400 patients used statins and 2% experienced statin intolerance.•1.5% had statin-associated myasthenic worsening and ptosis was a primary symptom.•Symptoms improved within only a few months with cessation of statin use.•Statins should be used and monitored in MG patients if needed.•Statin-associated myasthenic worsening should be added in classical statin intolerance.</description><subject>Acetylcholine receptor</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atorvastatin - adverse effects</subject><subject>Atorvastatin - therapeutic use</subject><subject>Cohort Studies</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myasthenia gravis</subject><subject>Myasthenia Gravis - chemically induced</subject><subject>Myasthenia Gravis - drug therapy</subject><subject>Neuromuscular junction</subject><subject>Registries</subject><subject>Statin intolerance</subject><subject>Unmasking</subject><issn>0022-510X</issn><issn>1878-5883</issn><issn>1878-5883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1Lw0AURQdRbK3-ADeSpZvEeZNMMoMrEb-g4EbR3TCZvNgJTVLzpkr_vSmtLl09Lpx74R3GzoEnwCG_apKmo0RwkSUgUpDZAZuCKlQslUoP2ZRzIWIJ_H3CTogaznmulD5mk1RDJrgSU6be-oGw891H1NdRu7EUFmN0EW3aVehbiixR77wNWEXfPiwiCjb4jk7ZUW2XhGf7O2Ov93cvt4_x_Pnh6fZmHjuRyhBbnueANVZcyCyzANpmlQULKhe5LnShHKgMnHSpAixzlForXpYFiLoolExn7HK3uxr6zzVSMK0nh8ul7bBfk0m5TqEAqfmIwg51Q080YG1Wg2_tsDHAzVaYacwozGyFmZ2wsXOxn1-XLVZ_jV9DI3C9A3B88svjYMh57BxWfkAXTNX7f-Z_AEApels</recordid><startdate>20240915</startdate><enddate>20240915</enddate><creator>Sugimoto, Takamichi</creator><creator>Suzuki, Shigeaki</creator><creator>Uzawa, Akiyuki</creator><creator>Yamawaki, Takemori</creator><creator>Masuda, Masayuki</creator><creator>Minami, Naoya</creator><creator>Kawaguchi, Naoki</creator><creator>Kubota, Tomoya</creator><creator>Takahashi, Masanori P.</creator><creator>Suzuki, Yasushi</creator><creator>Watanabe, Genya</creator><creator>Konno, Shingo</creator><creator>Kimura, Takashi</creator><creator>Samukawa, Makoto</creator><creator>Ishizuchi, Kei</creator><creator>Akamine, Hiroyuki</creator><creator>Onishi, Yosuke</creator><creator>Yasuda, Manato</creator><creator>Nagane, Yuriko</creator><creator>Maruyama, Hirofumi</creator><creator>Murai, Hiroyuki</creator><creator>Utsugisawa, Kimiaki</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240915</creationdate><title>Worsening of myasthenic symptoms associated with statins</title><author>Sugimoto, Takamichi ; Suzuki, Shigeaki ; Uzawa, Akiyuki ; Yamawaki, Takemori ; Masuda, Masayuki ; Minami, Naoya ; Kawaguchi, Naoki ; Kubota, Tomoya ; Takahashi, Masanori P. ; Suzuki, Yasushi ; Watanabe, Genya ; Konno, Shingo ; Kimura, Takashi ; Samukawa, Makoto ; Ishizuchi, Kei ; Akamine, Hiroyuki ; Onishi, Yosuke ; Yasuda, Manato ; Nagane, Yuriko ; Maruyama, Hirofumi ; Murai, Hiroyuki ; Utsugisawa, Kimiaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c235t-a0661efed02544a119a4da1a1862697978c1841c5c381eb6e59980bb712f77853</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acetylcholine receptor</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atorvastatin - adverse effects</topic><topic>Atorvastatin - therapeutic use</topic><topic>Cohort Studies</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myasthenia gravis</topic><topic>Myasthenia Gravis - chemically induced</topic><topic>Myasthenia Gravis - drug therapy</topic><topic>Neuromuscular junction</topic><topic>Registries</topic><topic>Statin intolerance</topic><topic>Unmasking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sugimoto, Takamichi</creatorcontrib><creatorcontrib>Suzuki, Shigeaki</creatorcontrib><creatorcontrib>Uzawa, Akiyuki</creatorcontrib><creatorcontrib>Yamawaki, Takemori</creatorcontrib><creatorcontrib>Masuda, Masayuki</creatorcontrib><creatorcontrib>Minami, Naoya</creatorcontrib><creatorcontrib>Kawaguchi, Naoki</creatorcontrib><creatorcontrib>Kubota, Tomoya</creatorcontrib><creatorcontrib>Takahashi, Masanori P.</creatorcontrib><creatorcontrib>Suzuki, Yasushi</creatorcontrib><creatorcontrib>Watanabe, Genya</creatorcontrib><creatorcontrib>Konno, Shingo</creatorcontrib><creatorcontrib>Kimura, Takashi</creatorcontrib><creatorcontrib>Samukawa, Makoto</creatorcontrib><creatorcontrib>Ishizuchi, Kei</creatorcontrib><creatorcontrib>Akamine, Hiroyuki</creatorcontrib><creatorcontrib>Onishi, Yosuke</creatorcontrib><creatorcontrib>Yasuda, Manato</creatorcontrib><creatorcontrib>Nagane, Yuriko</creatorcontrib><creatorcontrib>Maruyama, Hirofumi</creatorcontrib><creatorcontrib>Murai, Hiroyuki</creatorcontrib><creatorcontrib>Utsugisawa, Kimiaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the neurological sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sugimoto, Takamichi</au><au>Suzuki, Shigeaki</au><au>Uzawa, Akiyuki</au><au>Yamawaki, Takemori</au><au>Masuda, Masayuki</au><au>Minami, Naoya</au><au>Kawaguchi, Naoki</au><au>Kubota, Tomoya</au><au>Takahashi, Masanori P.</au><au>Suzuki, Yasushi</au><au>Watanabe, Genya</au><au>Konno, Shingo</au><au>Kimura, Takashi</au><au>Samukawa, Makoto</au><au>Ishizuchi, Kei</au><au>Akamine, Hiroyuki</au><au>Onishi, Yosuke</au><au>Yasuda, Manato</au><au>Nagane, Yuriko</au><au>Maruyama, Hirofumi</au><au>Murai, Hiroyuki</au><au>Utsugisawa, Kimiaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Worsening of myasthenic symptoms associated with statins</atitle><jtitle>Journal of the neurological sciences</jtitle><addtitle>J Neurol Sci</addtitle><date>2024-09-15</date><risdate>2024</risdate><volume>464</volume><spage>123154</spage><pages>123154-</pages><artnum>123154</artnum><issn>0022-510X</issn><issn>1878-5883</issn><eissn>1878-5883</eissn><abstract>The common presentations of statin intolerance are muscle-specific symptoms. Although statins are one type of drug reported to cause myasthenic worsening, myasthenic worsening has not been recognized as statin intolerance. The purpose of the present study is to investigate in a large cohort the safety profiles of statins in patients with myasthenia gravis (MG).
A total of 1710 consecutive patients with MG who visited sites associated with the Japan MG registry 2021 group between April and October 2021 were reviewed. Statin-associated myasthenic worsening was defined as worsening of any myasthenic symptoms on statin use and improvement of the symptom by stopping the statin or by undertaking additional treatment with patient and doctor confirmation.
Among the 400 patients who used statins, 8 (2%) patients experienced statin intolerance and 6 (1.5%) patients experienced myasthenic worsening. No patients developed MG on the statin. Ptosis was a main symptom of myasthenic worsening in 4 (67%) patients. Atorvastatin was used in all patients with statin-associated myasthenic worsening. The symptoms of statin intolerance and statin-associated myasthenic worsening were improved within 2 months and 3 months, respectively, in all patients by cessation of statin use.
Regarding statin-associated myasthenic worsening, prevalence was low, and severity was mild; with cessation of statin use, symptoms improved within a few months, and outcomes were generally good. Although statins can be used in MG patients with little concern, statin-associated myasthenic worsening should be noted in addition to the classical statin intolerance associated with statin use.
•In 1710 MG patients, 400 patients used statins and 2% experienced statin intolerance.•1.5% had statin-associated myasthenic worsening and ptosis was a primary symptom.•Symptoms improved within only a few months with cessation of statin use.•Statins should be used and monitored in MG patients if needed.•Statin-associated myasthenic worsening should be added in classical statin intolerance.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>39142082</pmid><doi>10.1016/j.jns.2024.123154</doi></addata></record> |
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| subjects | Acetylcholine receptor Adult Aged Aged, 80 and over Atorvastatin - adverse effects Atorvastatin - therapeutic use Cohort Studies Disease Progression Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Japan - epidemiology Male Middle Aged Myasthenia gravis Myasthenia Gravis - chemically induced Myasthenia Gravis - drug therapy Neuromuscular junction Registries Statin intolerance Unmasking |
| title | Worsening of myasthenic symptoms associated with statins |
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