Statins are a class of
lipid-lowering medications that reduce illness and mortality in those who are at a high risk of developing
cardiovascular disease. They are the most common
cholesterol-lowering drugs. A case control study published in 2002 indicated that
statins may increase the risk of
peripheral neuropathy.
Statin users were 14-fold more likely to develop
peripheral neuropathy than non-users, although the overall risk of developing neuropathy was minimal. However, a number of other studies have produced conflicting results regarding neuropathy and
statins.
Statins are frequently combined with
niacin (
vitamin B3). Due to its beneficial effects on
lipid profiles,
niacin has been prescribed for the prevention of
heart disease for >40 years. Among the
B vitamins,
niacin has long been recognized as a key mediator of neuronal development and survival, and may be of value for the treatment of neuropathy. The present study aimed to assess whether the combination of
niacin and
statin may reduce the risk of
peripheral neuropathy attributed to
statins. For this purpose, data from MedWatch, the Food and Drug Administration (FDA) Safety Information and Adverse Event Reporting Program were analyzed. The online tool OpenVigil 2.1 was used to query the databases. The results revealed that the majority of
statins alone were related to neuropathy.
Pitavastatin was the only exception. The association with neuropathy was most pronounced in the lipophilic
statins:
Atorvastatin and
fluvastatin. The association was weaker for other lipophilic
statins, such as
lovastatin and
simvastatin. Two hydrophilic
statins,
rosuvastatin and
pravastatin, exhibited a similarly weaker association with neuropathy, while no reports of any association of
pitavastatin with neuropathy were found.
Statins +
niacin were unrelated to neuropathy. On the whole, the findings of the present study demonstrate that the controversial association of
statins with neuropathy may be due to the fact that previous studies have not included the use of
niacin and the potential
neuroprotective effects of
niacin. Multiple reports have stated that
niacin is no longer beneficial for the management of
hyperlipidemia and should be abandoned. However, given the apparent ability of
niacin to reduce the risk of neuropathy, perhaps
niacin should not be discarded before further studies are performed to provide more in depth information.