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CASE REPORT
Statin-induced myopathy prevented by creatine administration
  1. Maurizio Balestrino1,2,
  2. Enrico Adriano1
  1. 1Clinica Neurologica, Università degli Studi di Genova, Dipartimento di Neuroscienze Riabilitazione Oftalmologia Genetica e Scienze Materno-Infantili (DINOGMI), Genova, Italy
  2. 2Dipartimento di Neuroscienze e Organi di Senso, IRCCS Policlinico San Martino, Genova, Italy
  1. Correspondence to Professor Maurizio Balestrino, mbalestrino{at}neurologia.unige.it

Summary

A 66-year-old woman with chronic myeloid leukaemia in nilotinib-induced remission was diagnosed with amaurosis fugax, caused by carotid stenosis. Serum cholesterol was 316 mg/dL (Low-Density Lipoprotein (LDL) cholesterol 213 mg/dL). Nilotinib was discontinued and replaced by interferon. Antiplatelet therapy and atorvastatin 40 mg/day were prescribed. Muscle pain and elevation of serum creatine kinase (CK) occurred; thus, atorvastatin was replaced by ezetimibe. Afterwards, muscle pain subsided and CK reverted to normal, but 2 years later serum cholesterol was still elevated at 218 mg/dL with LDL cholesterol 126 mg/dL. Simvastatin 5 mg/day was then started, but again muscle pain occurred and CK rose to 267 U/L. Simvastatin was stopped and serum cholesterol climbed to 252 mg/dL. Creatine was prescribed and simvastatin was reintroduced. Two months later, cholesterol was 171 mg/dL, CK was 72 U/L and there was no muscle pain. This case supports the view that creatine may prevent statin-induced myopathy.

  • cardiovascular system
  • lipid disorders
  • muscle disease
  • stroke
  • unwanted effects / adverse reactions
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Footnotes

  • Contributors MB provided patient’s care and contributed to write the report. EA contributed to write the report and provided useful discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MB and EA are founding members of NovaNeuro Srl, an academic spin-off that ideates, produces and commercialises dietary supplements based on creatine.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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