Treatment with statins and peripheral neuropathy: results of 36-months a prospective clinical and neurophysiological follow-up.

OBJECTIVES

To confirm the changes in the results of EMG assessment of lower-limb peripheral nerves in patients treated with statins in the longer follow-up period of 3 years.

BACKGROUND

Long-term treatment with statins may have adverse effects: affection of muscles or peripheral nervous system. The frequency of affection of the peripheral nervous system has not been thoroughly investigated; our previous study showed the signs of peripheral nerve damage in the results of EMG assessment.

DESIGN/

METHODS

Forty-two patients (23 males, 19 females, mean age 51.9 and 52.3 years) with a definitive diagnosis of combined hyperlipidemia were studied. Other metabolic disorders or chronic ethanol abuse were excluded. Initial examinations included laboratory and neurophysiological measures (peroneal and tibial nerves: MNCV, CMAP, F-wave mean latency; superficial peroneal and sural nerve: SNCV, SNAP). Subsequently, treatment with simvastatin 20 mg daily was initiated. Patients were followed for 36 months with repeated neurophysiological examinations on 24 and 36 months after statin treatment initiation.

RESULTS

None of the patients reported subjective symptoms typical for peripheral neuropathy. Neurophysiological examination of lower-limb peripheral nerves demonstrated statistically significant prolongation of F-wave mean latency on peroneal and tibial nerves (p<0.0001, paired t-test).

CONCLUSIONS

The study confirmed that long-term treatment with statins caused a clinically silent but still definite damage to peripheral nerves when the treatment lasts longer than 2 years.