Lu Ya-Wen, Wang Jong-Yi, Lin Heng-Jun, Chung Wei-Sheng
Pharmaceutical Department, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan.
Department of Health Services Administration, China Medical University, Taichung, Taiwan.
Ther Adv Drug Saf. 2025 Aug 11;16:20420986251365746. doi: 10.1177/20420986251365746. eCollection 2025.
Statins have been demonstrated to decrease cardiovascular events in high-risk patients. Statin-induced myotoxicity is a major contributor to statin intolerance and often the leading cause of statin discontinuation. Studies on the association between statin use and rhabdomyolysis risk remain limited.
This study aimed to compare the risk of rhabdomyolysis in patients who used statins versus those who did not.
A population-based case-control study was conducted.
Data were collected from the Taiwan National Health Insurance Research Database between 2011 and 2020, involving 186,604 individuals with rhabdomyolysis and 746,416 without. Each patient with rhabdomyolysis (case group) was matched with four control patients based on the index year. Statins were assessed in both groups.
Approximately 50% of study participants were male, with an average age of 53 years. After confounding variables were adjusted for, patients who used statins exhibited a higher risk of rhabdomyolysis than those who did not (adjusted odds ratio (OR): 1.70, 95% confidence interval (CI): 1.68-1.73). Psychiatric disorders, alcoholism, generalized epileptic seizure, heat stroke, and crush injury were independent risk factors of rhabdomyolysis. Patients with psychiatric disorders who used statins exhibited a substantial risk of rhabdomyolysis (adjusted OR: 2.30, 95% CI: 1.95-2.71) compared with the reference group of patients without psychiatric disorders who did not use statins.
Statin use was associated with a higher risk of rhabdomyolysis, and patients with psychiatric disorders who used statins exhibited an additive risk of rhabdomyolysis. These findings emphasize the need for clinicians to remain attentive to the potential risk of rhabdomyolysis in patients prescribed statins, especially in those with psychiatric disorders. Proactive monitoring, early recognition of symptoms, and individualized risk-benefit assessments are crucial to optimize treatment outcomes while minimizing adverse effects.
他汀类药物已被证明可降低高危患者的心血管事件发生率。他汀类药物引起的肌毒性是导致他汀类药物不耐受的主要因素，且常常是停用他汀类药物的首要原因。关于他汀类药物使用与横纹肌溶解症风险之间关联的研究仍然有限。
本研究旨在比较使用他汀类药物的患者与未使用他汀类药物的患者发生横纹肌溶解症的风险。
开展了一项基于人群的病例对照研究。
收集了2011年至2020年台湾地区国民健康保险研究数据库中的数据，涉及186604例横纹肌溶解症患者和746416例无横纹肌溶解症的患者。根据索引年份，为每例横纹肌溶解症患者（病例组）匹配4例对照患者。对两组患者均评估他汀类药物的使用情况。
约50%的研究参与者为男性，平均年龄为53岁。在对混杂变量进行调整后，使用他汀类药物的患者发生横纹肌溶解症的风险高于未使用他汀类药物的患者（调整后的比值比（OR）：1.70，95%置信区间（CI）：1.68 - 1.73）。精神疾病、酗酒、全身性癫痫发作、中暑和挤压伤是横纹肌溶解症的独立危险因素。与未使用他汀类药物的无精神疾病的参照组患者相比，使用他汀类药物的精神疾病患者发生横纹肌溶解症的风险显著升高（调整后的OR：2.30，95%CI：1.95 - 2.71）。
使用他汀类药物与较高的横纹肌溶解症风险相关，且使用他汀类药物的精神疾病患者发生横纹肌溶解症的风险更高。这些发现强调临床医生有必要持续关注开具他汀类药物处方的患者发生横纹肌溶解症的潜在风险，尤其是那些患有精神疾病的患者。主动监测、早期症状识别以及个体化的风险效益评估对于优化治疗效果同时将不良反应降至最低至关重要。
