Statin-related myopathy and vitamin D

Abstract

Statins are usually safe and well tolerated drugs, very effective for preventing cardiovascular complications. The rare presence of myalgia, with different incidence as reported by several studies, is one of the causes of lack of drug compliance. Also the different symptoms referred (myalgia, myopathy, rhabdomyolysis) and the lack of objetivity of each patient when referring to the symptoms, have created confusion in this matter.
Associations between decreased vitamin D levels and increased risk of myopathy has been reported. Indeed, studies describing patients with vitamin D deficiency who are not compliant due to myalgia show that they become tolerant to the drugs once the vitamin is supplemented to desirable values.
The presence of gene polymorphisms for enzymes that metabolize or transport statins is another factor clearly related to myopathy.
Therefore, we should consider vitamin D deficiency and other conditions such as the simultaneous administration of drugs that are
metabolized by the same cytochrome P450 pathway, or the presence of mentioned polymorphisms as a risk factor for developing
myopathy due to statins. In conclusion, the finding that vitamin D deficiency is associated with statin myopathy, or is a risk factor
its develpoment, opens new perspectives for a large number of patients who leave this treatment due to this condition.