Wednesday 5 June 2013

Claim that statins damage muscles 'overblown'

Claim that statins damage muscles 'overblown': "Statins could lead to muscular injuries, scientists warn,” reports The Daily Telegraph.
The headline is based on a new study looking at whether statins  – drugs used to reduce blood cholesterol levels – increased the risk of damage and pain to muscles and bones.

The study involved US soldiers, veterans and their families, comparing the likelihood of musculoskeletal conditions among statin users with non-users. The study found that musculoskeletal conditions, injuries and pain are more common among statin users than non-users. However, the actual increase was very small; varying between 1% and 3%. On average, 85% of non-users reported having a musculoskeletal condition compared to 87% of statin users.
While any noticeable adverse effects are obvious and make for a simple news story, the benefits (such as reducing risk of heart attacks, heart disease, and stroke) can be more difficult to see.
For the vast majority of people prescribed a statin, these benefits are likely to outweigh any small increase in risk of musculoskeletal problems.

Where did the story come from?

The study was carried out by researchers from Brooke Army Medical Centre, the Uniformed Service University of Health Sciences, the University of Texas, and the South Texas and North Texas Veterans Affairs Health Care Systems. It was funded by the US National Institutes of Health.
The study was published in the peer-reviewed journal JAMA Internal Medicine.
This research was widely reported in the media and the reporting was mixed. However, the Mail's headline may have given the impression that the risk of muscle damage to statin users was very high.
The coverage of the study itself was accurate. The Daily Mail’s coverage was particularly good, placing the increase in risk in an appropriate context as well as providing expert opinion on the benefits of statins.

What kind of research was this?

This was a retrospective cohort study which aimed to determine whether statin use is associated with musculoskeletal conditions, including joint disease (such as osteoarthritis) and injury, in a military healthcare system. 
In this study, statin users were matched with non-users so their baseline characteristics were similar.
A cohort study is the ideal study design to address this question. However, despite the fact that the researchers tried to ensure there were as few differences as possible between statin users and statin non-users at baseline, it is possible that other factors (confounders) are responsible for the associations seen. A randomised controlled trial would be required to show a cause and effect relationship.

Links To The Headlines

Statins could lead to muscular injuries, scientists warn. The Daily Telegraph, June 4 2013
Statins can weaken muscles and joints: Cholesterol drug raises risk of problems by up to 20 per cent. Daily Mail, June 4 2013
Statins linked to pain in joints. Daily Express, June 4 2013

Links To Science

Mansi I, Frei CR, Pugh MJ, et al. Statins and Musculoskeletal Conditions, Arthropathies, and Injuries. JAMA Internal Medicine. Published online June 3 2013

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