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Statins: tendon damage rare but sufficient to warrant monitoring

Tendon damage caused by statins seems to be rare but warrants clinical monitoring during the first year of treatment, especially when there are risk factors.

A French regional pharmacovigilance centre has published a study of tendinopathies (tendon damage) caused by statins. Statins are cholesterol-lowering treatments widely used in cardiovascular prevention. These treatments, pravastatin and simvastatin in particular, are effective in reducing morbidity and mortality but their adverse effects include muscular disorders and tendon damage.

More than 100 tendinopathies have been attributed to statins in France. In most cases, they occur during the first year of treatment (after 8 months) and in the following situations in particular: male, diabetes, high level of uric acid, practising a sport, history of tendon injury.

Tendinopathies generally manifest themselves as tendonitis, tendon rupture, accompanied by pain, oedema, redness, an increase in local temperature, disability.

In more than 50% of cases, the Achilles tendon is affected, sometimes the femoral quadriceps tendon. The injury is sometimes bilateral. Treatment (halting the statin, immobilisation and analgesic treatment) often allows the signs to diminish, but sometimes hospitalisation is necessary and there may be functional after-effects.

Overall, tendinopathy caused by statins is rare but should be watched for during the first year of treatment.

©Prescrire May 2010

"Tendon disorders due to statins" Prescrire Int 2010; 19 (106): 73 (pdf, subscribers only).


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