Statins ruled out as culprit for tendon rupture


Much-maligned statins have received a rare positive shot in the arm, with a new review showing they are not associated with tendon rupture – and may even reduce the risk of tendinopathy.

A systematic review published in the Medical Journal of Australia this week debunked previous conjecture linking statin use with tendon ruptures.

Lead author and Melbourne rheumatologist Dr Andrew Teichtahl said the review included four studies published between 2009-2015, three of which had tendon rupture as the primary outcome and rotor cuff disease as the fourth.

He said they had found no study reported an association between statin therapy and tendon rupture, adding that this class of drugs had received a “fair amount” of negative attention, and it was “nice to see an unbiased opinion to give statins a bit of a rap really.”

“A lot of the stuff with the statins is a bit of a storm in a teacup,” he told the limbic.

“The message for specialists is that there is no evidence for increased risk and there may actually be a reduction in risk. There is no need to worry about ruptures with statins.”

He said the discovery that statins may potentially play a preventive role was quite exciting, but it would need to be studied further.

“I think it could lead to future studies and clinical trials,” he said.

The authors speculated that case reports of tendon rupture among statin users had gained notoriety because of the “extreme nature” of the ruptures, however, “many of these reports are complicated by other risk factors for tendinopathy, such as hypercholesterolemia, diabetes mellitus, fluoroquinolone use or extreme exercise.”

Dr Teichtahl said it might seem “very easy” to blame the statins, but they were simply not the culprit in this case.

“It is therefore very difficult to distinguish whether tendinopathy was a result of drug intervention or whether it was a pathological process necessitating statin therapy that increased the risk of tendinopathy,” the authors wrote.

Statins use took a big hit in 2013 when the ABC show Catalyst aired a two-part program that questioned the link between heart disease and cholesterol, as well as their extensive use.

The episodes were widely criticised by the National Heart Foundation, as well as a large number of doctors and specialists concerned that patients were turning their backs on statins, while a subsequent investigation by the ABC’s Independent Audience and Consumer Affairs Unit found the episodes breached the ABC’s standards on impartiality.

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