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Some — but not all — observational studies have suggested an association between statins and polyneuropathy. In this latest case-control study, Dutch researchers at a university neuromuscular clinic identified 333 cases of distal symmetrical sensory or sensorimotor neuropathy without known cause. These cases were compared with 283 healthy controls who had neither polyneuropathy nor its common risk factors (e.g., diabetes, excessive alcohol use).
Statin use prior to onset of symptoms was noted in 13% of cases and in 21% of controls. In analyses adjusted for numerous potentially confounding variables, statin use was not associated with excess risk for polyneuropathy.
Warendorf JK et al. Statins do not increase risk of polyneuropathy. Neurology 2019 Apr 30; 92:e2136. (https://doi.org/10.1212/WNL.0000000000007148)
Comment
In a recent American Heart Association scientific statement on adverse effects of statins, the authors noted that an association between statins and neuropathy had been noted in some observational studies but not in randomized trials (NEJM JW Gen Med Mar 1 2019 and Arterioscler Thromb Vasc Biol 2019; 39:38). This new study tilts the scale further against a causal association. Some statin-treated patients who develop unexplained polyneuropathy might wish to stop the drug, but they should be informed that we have no compelling evidence that statins cause neuropathy.