Effect of statins on skeletal muscle function

BA Parker, JA Capizzi, AS Grimaldi, PM Clarkson… - Circulation, 2013 - Am Heart Assoc
BA Parker, JA Capizzi, AS Grimaldi, PM Clarkson, SM Cole, J Keadle, S Chipkin
Circulation, 2013Am Heart Assoc
Background—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. Methods and Results—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 …
Background
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.
Methods and Results
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).
Conclusions
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.
Clinical Trial Registration
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00609063.
Am Heart Assoc