Using Statins and Fibrates Increase Risk of Peripheral Neuropathy

Those on Statins and Fibrates showed an increased risk of peripheral neuropathy greater then those on only statins. Although lipid lowering drugs are effective in preventing morbidity and mortality from cardiovascular events, the extent of their adverse effects is not clear. This population based case-control study, carried out by linkage of several automated databases, explored the association between prescription of lipid lowering drugs and the risk of peripheral neuropathy.

Using a resident population of a northern Italian Province aged 40 years or more, cases were patients discharged for peripheral neuropathy in 1998-1999. For each case up to 20 controls were randomly selected among those eligible. Altogether 2040 case patients and 36 041 controls were included in the study. Prescription drug database was used to assess exposure to lipid lowering drugs at any time in the one year period preceding the index date. Conditional logistic regression model for matched data was used to estimate the risk of peripheral neuropathy associated with exposure to statins, fibrates, and other lipid lowering drugs.

They found that weak but significant effects of lipid lowering drugs as a whole (matched odds ratio:1.27), statins (1.19), and fibrates (1.49) were observed. Significant linear trends towards increased risk at increased exposure to both statins and fibrates were observed.

The researchers concluded: "The use of both statins and fibrates was associated with the risk of peripheral neuropathy. The primary purpose of this exploratory study is signal generation.

Journal of Epidemiology and Community Health 2004;58:1047-1051.

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FACT:

A new risk marker for advanced stages of diabetic retinopathy in patients with type 2 diabetes has been described. The marker is a late oxidative product of N-carboxymethyl-lysine. It was chosen because it apparently is a biomarker of glycation and oxidation reaction. Serum levels were shown to be a progressive risk marker. A level of > 1,000 ng/ml resulted in a 20-fold increase in the risk of proliferative retinopathy and clinically significant macula oedema. Diabetologia,47 (1376-1379)

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