Metformin Reduces Mild Statin-Induced Myalgia
Risk of non-severe statin muscle pain was reduced in T2DM patients taking both metformin and statins, according to this recent study.
Metformin Reduces Mild Statin-Induced Myalgia
Metformin for Myalgia? AMPK counter-regulates downstream mediators of the insulin-like growth factor 1/phosphatidylinositol-3-kinase/Protein Kinase B (IGF-1/PI3K/AKT) which is associated with statin-induced muscle pain.
The Study. The authors reanalyzed data from the ACCORD trial and identified two groups: statin (and other medications) without metformin and statin (and other medications) with metformin. Multivariable regression was also used to determine if metformin had any effect on reports of muscle pain in statin-treated patients.
The Results. A1c was similar between groups: statin only vs metformin and statin, respectively (7.6 +/-1.3 vs 7.5 +/-1.1%), as was eGFR (74 +/-27 vs 78 +/- 25 mL/min/1.73m2) and ALT(27 +/-1 4 vs 27 +/-14 IU/L).
Take Home Messages:
- Patients with T2DM who take statins for CV risk reduction may benefit from metformin if they have muscle aches attributed to statin therapy.
- Mitigation of negative side effects may improve adherence to statin therapy.
- Metformin appears to be more effective than Co-enzyme Q10 and vitamin D supplementation vs treatments for statin-induced muscle pain.
- Physicians should only administer metformin if there is a co-indication.
Nicholas Carris, PharmD and colleagues in Florida discovered that taking metformin for type-2 diabetes reduced the risk of non-severe statin muscle pain in patients taking both. Scroll through the slides above for details from the study and for clinical take home points.For more information: Carris NW, Tsalatsanis A, Tipparaju SM, et al. Metformin's impact on statin-associated muscle symptoms: An analysis of ACCORD study data and research materials from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center. Diabetes Obes Metab. 2018;1-6. DOI: 10.1111/dom.13302