Peripheral neuropathy development in patients after long term statin use

Statins; are considered to be first-line drugs used for lowering low-density lipoprotein cholesterol levels which is an independent risk factor for cardiovascular disease and one of the leading causes of death around the World. As one of the commonly used drugs, side effects of statins can not be ignored. The aim of the study was to determine the peripheral neuropathy side effect on patients who were prescribed statins in Celal Bayar University Department of Cardiology Out-patient clinic and have been using the drug for more than a year. The study group was selected from non-drug users who has been prescribed statins on indication and had none of the exclusion criteria. Statin users were grouped as atorvastatin and rosuvastatin users, depending on the dosage and length of drug use. All groups were neurologically examined by Celal Bayar University Physical therapy and rehabilitation clinic and ENMG tests were performed. All patients went through advanced physical examination. Polyneuropathy was graded according to the findings. There was no significant difference in terms of age and sex between study and control groups, on the other hand male population was found to be dominant in both groups. Incidence of peripheral neuropathy was found to be statistically significantly higher in long term statin users (p<0,001). Between the atorvastatin users polyneuropathy was diagnosed in 23 of the patients and 11 patients did not show any signs. On the other hand among the rosuvastatin users polyneuropathy was diagnosed in 10 of the patients and 6 patients did not show any signs. There was no statistically significant difference between two groups (p=0,720). Neurological findings of atorvastatin patients who has been using the drug less than a year showed 1 mild, 1 moderate polyneuropathy and 4 patients were healthy. Among the patients who has been using the drugs between 1 to 5 years; 3 patients were normal and 13 patients showed mild polyneuropathy. Among the patients who has been using the drug for more then while 5 patients did not show any signs of pathology, 7 patients were diagnosed with polyneuropathy. There was a statistically significant difference in polyneuropathy incidence according to the time interval of atorvastatin use (p=0.03). Our study results support the argument that long term use of statins cause peripheral neuropathy. Physical examination findings of the patients who were diagnosed with neuropathy were also correlated with ENMG results. In patients with chronic statin use; in case of prickling, numbness, pain, trembling of the hand and feet, instability during walking, muscle weakness, atrophy and autonomic findings peripheral neuropathy should be kept in mind and these patients should be further evaluated. When diagnosis of polyneuropathy depending on statin use is suspected, change of treatment regime or lowering of the drug dose should be considered.