> Most patients on statins do not have a raised CK.
> William M
I also agree with this. However, there is no doubt that muscle
effects are more likely at high statin doses and particularly in
the presence of other drugs which are metabolised by the
cytochrome p450 pathway and therefore may alter statin levels
(Med J Aust 2001 Nov 5;175(9):486-9. Statin-associated myopathy.
Hamilton-Craig I.
Ann Pharmacother 2001 Sep;35(9):1096-107. Rhabdomyolysis and
HMG-CoA reductase inhibitors. Omar MA, Wilson JP, Cox TS.)
I also agree that it is important to exclude all of the
secondary causes of hyperlipidaemia in the face of a poor
response to treatment (hypothyroidism, nephrotic syndrome etc).
Assuming secondary causes are absent, with a cholesterol level
this high familial hypercholesterolaemia must be a distinct
possibie. Response to statins in FH may be partly influenced by
the nature of the LDL receptor mutation if this is the
case.
Best wishes
Ian Young
----------------------
Professor IS Young
Department of Medicine
Wellcome Research Laboratories
Mulhouse Building
Royal Victoria Hospital
Grosvenor Road
Belfast BT12 6BJ
Northern Ireland
tel: +44 2890 263106
fax: +44 2890 235900
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