Effect of Statins on Skeletal Muscle Function

• Published in: Circulation (New York, N.Y.) Vol. 127; no. 1; pp. 96 - 103
• Main Authors: Parker, Beth A., Capizzi, Jeffrey A., Grimaldi, Adam S., Clarkson, Priscilla M., Cole, Stephanie M., Keadle, Justin, Chipkin, Stuart, Pescatello, Linda S., Simpson, Kathleen, White, C. Michael, Thompson, Paul D.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.01.2013
• Subjects: Adult; Antihypertensive agents; Atorvastatin Calcium; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular system; Creatine Kinase - blood; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Double-Blind Method; Exercise Test; Exercise Tolerance - drug effects; Female; Heptanoic Acids - administration & dosage; Heptanoic Acids - adverse effects; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Male; Medical sciences; Middle Aged; Muscle Strength - drug effects; Muscle, Skeletal - drug effects; Musculoskeletal Pain - chemically induced; Pharmacology. Drug treatments; Placebos; Pyrroles - administration & dosage; Pyrroles - adverse effects; Young Adult; Physical exercise; Enzyme; Enzyme inhibitor; Cardiovascular disease; Statin derivative; Hypocholesterolemic agent; Striated muscle; exercise test; muscle strength; HMG-CoA reductase inhibitor; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; hydroxymethylglutaryl-CoA reductase inhibitors; Oxidoreductases; Antilipemic agent; Myopathy
• ISSN: 0009-7322; 1524-4539; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.112.136101

Many clinicians believe that statins cause muscle pain, but this has not been observed in clinical trials, and the effect of statins on muscle performance has not been carefully studied. The Effect of Statins on Skeletal Muscle Function and Performance (STOMP) study assessed symptoms and measured creatine kinase, exercise capacity, and muscle strength before and after atorvastatin 80 mg or placebo was administered for 6 months to 420 healthy, statin-naive subjects. No individual creatine kinase value exceeded 10 times normal, but average creatine kinase increased 20.8±141.1 U/L (P<0.0001) with atorvastatin. There were no significant changes in several measures of muscle strength or exercise capacity with atorvastatin, but more atorvastatin than placebo subjects developed myalgia (19 versus 10; P=0.05). Myalgic subjects on atorvastatin or placebo had decreased muscle strength in 5 of 14 and 4 of 14 variables, respectively (P=0.69). These results indicate that high-dose atorvastatin for 6 months does not decrease average muscle strength or exercise performance in healthy, previously untreated subjects. Nevertheless, this blinded, controlled trial confirms the undocumented impression that statins increase muscle complaints. Atorvastatin also increased average creatine kinase, suggesting that statins produce mild muscle injury even among asymptomatic subjects. This increase in creatine kinase should prompt studies examining the effects of more prolonged, high-dose statin treatment on muscular performance. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00609063.