This article is more than 5 years old. Information may no longer be current.

Statins associated with increased risk for back disorders

Statin users were much more likely to be diagnosed with a back disorder than nonusers, according to findings published in JAMA Internal Medicine.

“Back pain results in tremendous disability and cost; therefore, understanding predisposing or protective factors deserves attention,” Una E. Makris, MD, MSc, from Veterans Affairs North Texas Health Care System in Dallas, and colleagues wrote. “Statins are widely used, but there is no consensus on whether statins are protective of or deleterious to musculoskeletal conditions.”

Since statins may heighten the risk for myalgias and back pain, Makris and colleagues evaluated the association between statin use and incidence of back disorder diagnoses, such as spondylosis and intervertebral disc disorders. They used health care data for patients older than 30 years with at least one medical encounter during the baseline and follow-up period who were enrolled in TRICARE in the San Antonio military area between Oct. 1, 2003, and March 1, 2012 (n = 60,455; 52.3% women; mean age, 46.6 years).

Participants were categorized into two groups: statin users (first-time statin users who continued using them for 120 days or more) and nonusers (patients who either had a history of statin use prior to the study period or who had never used statins). Frequent statin users were not included in the analysis. The researchers used a propensity score of 115 baseline characteristics to match 6,728 statin users with 6,728 nonusers in a 1:1 ratio.

Data indicated that statins, mainly simvastatin (72%), were used for a median of 3.7 years by historical statin users. The likelihood of back disorder diagnoses was higher in statin users (OR = 1.27; 95% CI, 1.19-1.36). The number needed to be exposed to identify an additional harm was 17, according to the researchers. Similar results were seen in all secondary analyses examining the ORs of outcomes in the overall cohort and various prespecified cohorts, including the longer use and higher intensity of statins, nonobese, healthy and musculoskeletal diseases incident cohorts.

“To our knowledge, this study is the first to report greater odds of back disorders among statin users compared with the odds of nonusers in a population with equal access to and the same cost of health care,” Makris and colleagues concluded.

“Our results provide additional motivation to further investigate the overall influence of statin therapy on musculoskeletal health, specifically if prescribed for primary prevention in physically active individuals,” they added. – by Alaina Tedesco

Disclosure: Makris and colleagues report receiving support for this research in part by the U.S. Department of Veterans Affairs at the Veterans Health Administration. Please see full study for complete list of all authors’ relevant financial disclosures.