A study led by an Indian researcher has found a gene known as atrogin-1, which plays a key role in statin-related muscle toxicity.
Statins, the popular class of drugs used to lower cholesterol, are among the most commonly prescribed medications, but for some patients, accompanying side effects of muscle weakness and pain become chronic problems and, in rare cases, can escalate to debilitating and even life-threatening damage.
The study, led by Vikas P. Sukhatme, MD, PhD, Vice Chair of Medicine for Interdepartmental and Translational Programs, Chief of the Division of Nephrology, and Chief of the Division of Interdisciplinary Medicine and Biotechnology at BIDMC, helps explain the source of these problems.
“Although it is not known exactly how many of the 500 million individuals who take statins experience muscle pain and weakness, muscle symptoms are generally considered the most common side effects of these medications,” Sukhatme said.
“Statin users describe a wide spectrum of symptoms – at the most extreme end is a severe breakdown of skeletal muscle known as rhabdomyolysis,” he said.
“At the other end is ‘grumbling muscles,’ milder, more diffuse muscle soreness and cramps. This kind of symptomatic muscle weakness and pain is quite frequent, but often difficult to quantitate,” he added.
Known by such trade names as Lipitor, Zocor, Pavacol and Mevacor, statins lower cholesterol by inhibiting HMG-CoA reductase, a key enzyme in cholesterol synthesis.
“We learned that atrogin-1 is rapidly turned on in wasting muscle,” said Lecker, an investigator in the Division of Nephrology at BIDMC and Assistant Professor of Medicine at HMS. Muscle wasting occurs in a large number of disease states, including cancer, AIDS, and kidney disease and can also occur when muscles are underused due to injury or lack of exercise.
