Analysis of vitamin D levels in patients with and without statin-associated myalgia - A systematic review and meta-analysis of 7 studies with 2420 patients

Marta Michalska-Kasiczak, Amirhossein Sahebkar, Dimitri P. Mikhailidis, Jacek Rysz, Paul Muntner, Peter P. Toth, Steven R. Jones, Manfredi Rizzo, G. Kees Hovingh, Michel Farnier, Patrick M. Moriarty, Vera A. Bittner, Gregory Y.H. Lip, Maciej Banach

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related symptomatic myalgia in statin-treated patients. The aim of this meta-analysis was to substantiate the role of serum vitamin D levels in statin-associated myalgia.

Methods The search included PUBMED, Cochrane Library, Scopus, and EMBASE from January 1, 1987 to April 1, 2014 to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Quantitative data synthesis was performed using a fixed-effect model.

Results The electronic search yielded 437 articles; of those 20 were scrutinized as full texts and 13 studies were considered unsuitable. The final analysis included 7 studies with 2420 statin-treated patients divided into subgroups of patients with (n = 666 [27.5%]) or without (n = 1754) myalgia. Plasma vit D concentrations in the symptomatic and asymptomatic subgroups were 28.4 ± 13.80 ng/mL and 34.86 ± 11.63 ng/mL, respectively. The combination of data from individual observational studies showed that vit D plasma concentrations were significantly lower in patients with statin-associated myalgia compared with patients not manifesting this side effect (weighted mean difference - 9.41 ng/mL; 95% confidence interval: - 10.17 to - 8.64; p < 0.00001).

Conclusions This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Randomized controlled trials are necessary to establish whether vitamin D supplementation reduces the risk for statin-associated myalgia.

Original languageEnglish (US)
Pages (from-to)111-116
Number of pages6
JournalInternational Journal of Cardiology
Volume178
DOIs
StatePublished - Jan 15 2015

Keywords

  • Myalgia
  • Statin intolerance
  • Statin-associated myalgia
  • Vitamin D

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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