Four cases of tendinopathy in patients on statin therapy

During the last decade, statins have been widely prescribed as lipid-loweri ng drugs. Their overall safety profile is good. The main musculoskeletal si de effects have consisted of muscle pain and weakness, peripheral neuropath y, and a few cases of drug-induced lupus. We report the first four cases of tendinopathy in patients receiving statin therapy. There were three men an d one woman. The diagnoses were extensor tenosynovitis at the hands (case 1 ), tenosynovitis of the tibialis anterior tendon (case 2), and Achilles ten dinopathy (cases 3 and 4). Two patients were on simvastatin and two on ator vastatin. The tendinopathy developed 1 to 2 months after treatment initiati on. The outcome was consistently favorable within 1 to 2 months after disco ntinuation of the drug. Similar cases have been reported to French pharmaco vigilance centers. This report of four cases of tendinopathy draws attentio n to a possible and heretofore unrecognized side effect of a drug class tha t is becoming increasingly popular. Statins are effective in lowering high cholesterol levels in patients with type IIa or IIb hypercholesterolemia. T hey have been widely used for the last decade, particularly in the secondar y and primary prevention of major coronary events. Statins act by inhibitin g the enzyme hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase. Alth ough most patients tolerate statins extremely well, a few experience side e ffects requiring treatment discontinuation. Reported musculoskeletal side e ffects include myalgia and a few cases of rhabdomyolysis and polymyositis. Induced lupus and peripheral neuropathy are exceedingly rare. Joint Bone Sp ine 2001 68: 430-3. (C) 2001 Editions scientifiques et medicales Elsevier S AS.