What exactly is the relationship between statins and tendinopathies?
Like other rare events, this is a phenomenon for which case reports can be more illuminating than larger studies. I liked this one for the pathophysiology explanation, and this was also a nice quick recap; both seem to show a temporal relationship between statin use and tenson problems. Seems like the larger analyses have not found any consistent relationship, though; one suggested women are at increased risk. The study I’m attaching here is a cohort study of patients who received new prescriptions with statins, propensity-score matched to patients who didn’t receive statins, and they found no relationship. As the authors point out, they only followed patients for five years, and they were only able to analyze for tendon rupture, not all tendinopathy, so there are some limitations. My guess (as a non-researcher!) is that the small number of people who develop tendon ruptures on statins have some underlying predisposition. I suppose a patient with a history of tendon issues would make me pause and have a more detailed conversation about risks and benefits of statins, but based on what I read today, no changes in practice for me. Let me know your thoughts!
Gowdar SD, Thompson PD. Multiple tendon ruptures associated with statin therapy. Journal of Clinical Lipidology. 2019;14(2):189-191. doi:https://doi.org/10.1016/j.jacl.2019.12.001
Moniri NH, Momary KM, McMahon T, Nayee E. Statin-Associated Achilles Tendon Rupture and Reproducible Bilateral Tendinopathy on Repeated Exposure. Mayo Clinic Proceedings. 2018;93(10):1531-1532. doi:https://doi.org/10.1016/j.mayocp.2018.08.005
Spoendlin J, Layton JB, Mundkur M, Meier C, Jick SS, Meier CR. The Risk of Achilles or Biceps Tendon Rupture in New Statin Users: A Propensity Score-Matched Sequential Cohort Study. Drug Safety. 2016;39(12):1229-1237. doi:https://doi.org/10.1007/s40264-016-0462-5
