Metformin's impact on statin-associated muscle symptoms: An analysis of ACCORD study data and research materials from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center.

Pubmed ID: 29577553

Journal: Diabetes, obesity & metabolism

Publication Date: Aug. 1, 2018

Link: https://onlinelibrary.wiley.com/doi/pdf/10.1111/dom.13302

MeSH Terms: Humans, Male, Female, Aged, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Hypercholesterolemia, United States, Middle Aged, Randomized Controlled Trials as Topic, Severity of Illness Index, Follow-Up Studies, Incidence, Diabetes Mellitus, Type 2, Risk, Muscle, Skeletal, Walking, National Heart, Lung, and Blood Institute (U.S.), Biological Specimen Banks, Hypoglycemic Agents, Electronic Health Records, Metformin, Myalgia, Muscle Cramp

Authors: Kumar A, Tsalatsanis A, Carris NW, Tipparaju SM, Cheng F, Magness RR

Cite As: Carris NW, Tsalatsanis A, Tipparaju SM, Cheng F, Magness RR, Kumar A. Metformin's impact on statin-associated muscle symptoms: An analysis of ACCORD study data and research materials from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center. Diabetes Obes Metab 2018 Aug;20(8):1994-1999. Epub 2018 Apr 23.

Studies:

Action to Control Cardiovascular Risk in Diabetes (ACCORD)

Abstract

Statins are widely prescribed, yet statin muscle pain limits their use, leading to increased cardiovascular risk. No validated therapy for statin muscle pain exists. The goal of the study was to assess whether metformin was associated with reduced muscle pain. A secondary analysis of data from the ACCORD trial was performed. An ACCORD sub-study assessed patients for muscle cramps and leg/calve pain while walking, typical non-severe statin muscle pain symptoms. We compared muscle pain between patients using a statin (n = 445) or both a statin and metformin (n = 869) at baseline. Overall patient characteristics were balanced between groups. Unadjusted analysis showed fewer reports of muscle cramps (35%) and leg/calve pain while walking (40%) with statins and metformin compared to statin only (muscle cramps, 42%; leg/calve pain while walking, 47%). Multivariable regression demonstrated a 22% odds reduction for muscle cramps (P = 0.049) and a 29% odds reduction for leg/calve pain while walking (P = 0.01). Metformin appears to reduce the risk of non-severe statin muscle pain and additional research is needed to confirm the findings and assess metformin's impact on statin adherence and related cardiovascular outcomes.