Table 2.
OR of increased CPK concentrations (compared with statin users with normal CPK concentrations) and of rhabdomyolysis (compared with statin users without rhabdomyolysis) stratified by clinical risk factors
| Risk factor§ | One to two times ULN* | Two to three times ULN* | Three to four times ULN* | >four times ULN* | Rhabdomyolysis† | Rhabdomyolysis or >10 times ULN† |
|---|---|---|---|---|---|---|
| Adjusted OR (95% CI)‡ | Adjusted OR (95% CI)‡ | Adjusted OR (95% CI)‡ | Adjusted OR (95% CI)‡ | Adjusted OR (95% CI)‡ | Adjusted OR (95% CI)‡ | |
| Recent record of myalgia | 1.04 (0.97, 1.11) | 1.15 (0.99, 1.35) | 1.12 (0.84, 1.49) | 1.73 (1.37, 2.18) | 23.90 (2.03, 281.50) | 47.02 (15.76, 140.20) |
| Recent prescribing history of | ||||||
| Antihypertensives | 1.00 (0.96, 1.04) | 1.00 (0.92, 1.09) | 1.10 (0.94, 1.29) | 1.13 (0.96, 1.32) | 0.95 (0.43, 2.13) | 0.90 (0.63, 1.28) |
| CYP3A4 interacting drugs | 0.93 (0.87, 0.99) | 0.98 (0.85, 1.13) | 1.13 (0.88, 1.45) | 1.28 (1.02, 1.60) | 3.71 (1.18, 11.61) | 1.83 (1.10, 3.04) |
| Non-CYP3A4 interacting drugs | 1.14 (1.05, 1.24) | 1.12 (0.93, 1.35) | 1.24 (0.89, 1.73) | 1.31 (0.97, 1.79) | 0.72 (0.21, 2.54) | 1.08 (0.58, 2.02) |
| Oral corticosteroids | 0.72 (0.65, 0.80) | 0.95 (0.77, 1.17) | 0.90 (0.625, 1.32) | 1.12 (0.81, 1.55) | 2.40 (0.63, 9.09) | 1.73 (0.92, 3.22) |
| Number of non-statin prescriptions in previous 3 months | ||||||
| 1–3 | 0.94 (0.87, 1.01) | 0.90 (0.75, 1.08) | 0.87 (0.61, 1.24) | 0.80 (0.57, 1.12) | 0.37 (0.02, 5.41) | 0.84 (0.33, 2.16) |
| 4–8 | 0.87 (0.80, 0.94) | 0.83 (0.69, 0.99) | 1.06 (0.76, 1.49) | 0.79 (0.56, 1.12) | 1.24 (0.12, 12.77) | 1.05 (0.42, 2.61) |
| 9–18 | 0.85 (0.79, 0.92) | 0.85 (0.71, 1.03) | 1.03 (0.72, 1.48) | 0.96 (0.68, 1.36) | 1.79 (0.16, 19.96) | 1.64 (0.66, 4.06) |
| 19–49 | 0.87 (0.80, 0.95) | 1.04 (0.84, 1.27) | 1.20 (0.81, 1.77) | 1.31 (0.90, 1.91) | 3.04 (0.25, 36.69) | 2.03 (0.78, 5.28) |
| 50+ | 0.90 (0.75, 1.06) | 0.88 (0.58, 1.33) | 1.28 (0.63, 2.57) | 1.44 (0.77, 2.69) | 13.52 (1.03, 177.3) | 3.68 (1.18, 11.51) |
| Medical history of | ||||||
| Hyperthyroidism | 1.00 (0.87, 1.14) | 0.90 (0.64, 1.25) | 1.18 (0.72, 1.97) | 1.87 (1.24, 2.80) | – | 1.81 (0.71, 4.64) |
| Hypothyroidism | 1.13 (1.06, 1.20) | 1.33 (1.15, 1.53) | 1.54 (1.20, 1.96) | 1.41 (1.11, 1.79) | 0.74 (0.21, 2.62) | 1.51 (0.92, 2.48) |
| Diabetes mellitus | 0.97 (0.93, 1.00) | 0.99 (0.90, 1.08) | 1.10 (0.94, 1.29) | 1.01 (0.86, 1.18) | 1.31 (0.68, 2.55) | 1.03 (0.73, 1.44) |
| Chronic obstructive pulmonary disease | 1.10 (1.02. 1.18) | 1.09 (0.91, 1.29) | 1.20 (0.88, 1.62) | 1.27 (0.96, 1.67) | 0.25 (0.05, 1.22) | 1.26 (0.70, 2.26) |
Patients with increased CPK concentrations were compared with unmatched statin users with normal CPK concentrations.
Patients with rhabdomyolysis (or with >10 times ULN CPK concentrations) were compared with matched statin users without rhabdomyolysis who did not have a CPK measurement or a CPK concentratrion below >10 times ULN.
Adjusted for body mass index, smoking status, number of non-statin prescriptions in the previous 3 months, recent prescribing of antihypertensives, CYP3A4 interacting drugs, non-CYP3A4 interacting drugs, oral corticosteroids, history of atrial fibrillation, hypothyroidism, hyperthyroidism, chronic obstructive pulmonary disease or diabetes mellitus; in the comparisons with normal CPK, the analyses were also adjusted for age and gender.
Reference group are patients without the risk factor (or no non-statin prescriptions in the previous 3 months).