Sakado, Japan—When statin-induced muscle pain and other musculoskeletal adverse events (MAEs) appear in some patients varies considerably within the drug class, a new study suggests.

The report in Pharmacology Research & Perspectives examined the timing of MAEs, using information from the FDA Adverse Event Reporting System Data Files, focusing on atorvastatin, rosuvastatin, simvastatin, lovastatin, fluvastatin, pitavastatin, and pravastatin.

Researchers from Japan’s Josai University determined that the onset timing of statin-induced musculoskeletal adverse events differed with each statin. For example, the onset of MAEs was significantly faster with high-intensity statins, including atorvastatin and rosuvastatin, than with simvastatin.

On the other hand, the study team did not find that concomitant use of drugs—even those that may increase the risk of MAEs—did not cause changes in the onset timing of MAEs associated with statins.

For the study, the onset timing of MAEs during statin monotherapy was evaluated by determining the difference between statin start date and MAE onset date.

The use of concomitant drugs with statin therapy was included in the analysis, and researchers compared statins used in combination with concomitant drugs with statin monotherapy to determine if the use of concomitant drugs shifted the onset timing of MAEs.

Results indicated that the onset of MAEs was significantly faster with atorvastatin and rosuvastatin than with simvastatin. No difference in onset timing was detected with other statins, however, because the number of cases was too small for analysis, the authors note.

“When evaluating concomitant drug use, the concomitant drugs that shifted the onset timing of MAEs could not be detected,” study authors wrote. “Statins with strong low-density lipoprotein cholesterol-lowering effects (atorvastatin and rosuvastatin) contributed not only to a high risk of MAE onset, but also to a shorter time-to-onset. No concomitant drug significantly shifted the onset timing of MAEs when used concurrently with statins.”

“Passive surveillance of adverse events has played a major role in securing drug safety as a system to detect unknown adverse events. Data mining using Food and Drug Administration Adverse Event Reporting System, which is a large-scale database, will be an aid to enhance drug safety,” added senior author Daiuke Kobayashi, PharmD, of Josai University, in Japan.

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