Giant Cell Arteritis and Polymyalgia Rheumatica After Reexposure to a Statin: A Case Report
Authors: Hilda J.I. de Jong, Ronald H.B. Meyboom, Markku J. Helle, Olaf H. Klungel, Leo Niskanen, Jan Willem Cohen Tervaert
Journal: Annals of Internal Medicine (2014)

Letters21 October 2014Giant Cell Arteritis and Polymyalgia Rheumatica After Reexposure to a Statin: A Case ReportHilda J.I. de Jong, MSc, Ronald H.B. Meyboom, MD, Markku J. Helle, MD, Olaf H. Klungel, PharmD, Leo Niskanen, MD, and Jan Willem Cohen Tervaert, MDHilda J.I. de Jong, MScFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands., Ronald H.B. Meyboom, MDFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands., Markku J. Helle, MDFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands., Olaf H. Klungel, PharmDFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands., Leo Niskanen, MDFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands., and Jan Willem Cohen Tervaert, MDFrom Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5020-6 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Statins, or 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, are widely used to prevent cardiovascular diseases and are generally regarded as safe. However, adverse reactions, such as myalgia, myositis, rhabdomyolysis, muscle weakness, and cramps with or without elevated serum creatine kinase levels, may occur (1). Furthermore, we have recently described that statins may also be associated with polymyalgia rheumatica (PMR) (2).Case Report: A 78-year-old woman presented in December 2003 with muscle pain in the hips and shoulders and morning stiffness. She had a history of hypercholesterolemia treated with atorvastatin, 10 mg/d, for 9 months and hypertension treated with candesartan, 8 ...References1. Rallidis LS, Fountoulaki K, Anastasiou-Nana M. Managing the underestimated risk of statin-associated myopathy. Int J Cardiol. 2012;159:169-76. [PMID: 21813193] doi:10.1016/j.ijcard.2011.07.048 CrossrefMedlineGoogle Scholar2. de Jong HJ, Saldi SR, Klungel OH, Vandebriel RJ, Souverein PC, Meyboom RH, et al. Statin-associated polymyalgia rheumatica. An analysis using WHO global individual case safety database: a case/non-case approach. PLoS One. 2012;7:e41289. [PMID: 22844450] doi:10.1371/journal.pone.0041289 CrossrefMedlineGoogle Scholar3. Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008;372:234-45. [PMID: 18640460] doi:10.1016/S0140-6736(08)61077-6 CrossrefMedlineGoogle Scholar4. Slot MC, Links TP, Stegeman CA, Tervaert JW. Occurrence of antineutrophil cytoplasmic antibodies and associated vasculitis in patients with hyperthyroidism treated with antithyroid drugs: a long-term followup study. Arthritis Rheum. 2005;53:108-13. [PMID: 15696557] CrossrefMedlineGoogle Scholar5. Vandebriel RJ, De Jong HJ, Gremmer ER, Klungel OH, Tervaert JW, Slob W, et al. Statins accelerate the onset of collagen type II-induced arthritis in mice. Arthritis Res Ther. 2012;14:R90. [PMID: 22537858] doi:10.1186/ar3814 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Maastricht University Medical Centre, Maastricht, the Netherlands; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Mikkeli Central Hospital, Mikkeli, Finland; Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; Pharmacovigilance, Finnish Medicines Agency Fimea, Helsinki, Finland; and Maastricht University, Maastricht, the Netherlands.Disclaimer: The funding source had no role in the design and conduct of the study; collection, analysis, or interpretation of the data; or decision to submit the manuscript for publication.Financial Support: The National Institute for Public Health and the Environment funded this study (project S340040). Dr. Klungel has received funding for pharmacoepidemiologic research from the Dutch private–public Top Institute Pharma (grant T6.101 Mondriaan) and the Innovative Medicines Initiative Joint Undertaking under grant agreement n8 115004, resources of which include financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations' in-kind contribution.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0027. 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