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Enjoy the video, and the book is available on Amazon.com here: https://www.amazon.com/Metabolic-Therapies-Orthopedics-Second-Kohlstadt/dp/1138039217

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July 31, 2018

Exposure to statin medications is associated with the development of idiopathic inflammatory myositis (IMM), new research suggests.

In a population-based case-controlled study of adults age 40 years and older in South Australia, there was an almost twofold increased likelihood of statin exposure in patients with IIM compared with controls.

The finding is published online July 30  in JAMA Internal Medicine.

“We want to underscore the importance of people with appropriate risk levels to take their statins, but when patients present with muscle weakness or aches and pains, clinicians should be aware about the possibility of inflammatory myositis,” lead author Gillian E. Caughey, PhD, Adelaide Medical School, University of Adelaide, South Australia, told theheart.org | Medscape Cardiology.

The musculoskeletal adverse effects associated with statin use are well known and include myalgia, estimated to affect between 7% and 29% of all statin users, and rhabdomyolysis, a rare condition with an incidence of 0.4 per 10,000 person-years. But these adverse effects resolve when statin treatment is discontinued, Caughey said.

Idiopathic inflammatory myositis is a group of rare, clinically heterogeneous, autoimmune muscular disorders with an estimated incidence of 0.1 per 100,000 persons per year to 1.0 per 100,000 persons per year.

“They are severe, debilitating conditions that can result in permanent disability and death, and unfortunately, do not go away when the statin is discontinued because the statin has triggered an autoimmune response. That is why these patients need to be treated aggressively with steroids to help try to get the condition under control,” she said.

Caughey and colleagues identified 221 patients diagnosed with histologically confirmed IIM from the South Australian Myositis Database between 1990 and 2014.

Population-based age- and sex-matched controls (n = 662) were obtained from the North West Adelaide Health Study between 2004 and 2006.

Sixty-eight (30.8%) of the patients with IIM were exposed to statins at the time of their diagnosis vs 142 (21.5%) of the controls (P = .005).

There was an almost twofold increased likelihood of statin exposure in patients with IIM compared with controls, for an adjusted odds ratio (AOR) of 1.79 (95% confidence interval [CI], 1.23 – 2.60; P = .001).

When patients with necrotizing myositis were excluded from the analysis, results were similar (AOR, 1.92; 95% CI, 1.29 – 2.86; P = .001).

The researchers also found an increase in the total number of cases of IIM and the proportion of patients with IIM exposed to statins between 2000 and 2014. From 2000 to 2002, 1 of 18 patients (5.6%) with IIM was exposed to a statin, and this increased to 21 of 43 (48.8%) from 2012 to 2014.

During this time period, statin use in the Australian population increased, from 62,378 per 100,000 population from 2000 through 2002 to 109,922 per 100,000 from 2012 through 2014.

“One of the strengths of our study is the database that we used. All of the cases had a histologically confirmed diagnosis, as opposed to just someone reporting muscle aches and pains, so we knew that they had inflammatory myositis, and we also knew the subtype,” Caughey said.

“Another strength, and one of the surprising findings, was that when we excluded the necrotizing myositis in our sensitivity analysis, we still found a significant association of statin exposure with the other types of inflammatory myositis,” she said.

In an accompanying editor’s note, Gregory Curfman, MD, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, cautions that the study assessed statin exposure by drug history in the medical record for the IIM cases and by prescription dispensing records in the controls, which may have resulted in misclassification bias.

“Thus, the association of IIM with statin therapy reported by Caughey et al cannot be considered definitive, although these are likely the best data currently available.”

Curfman concludes that statin-associated myopathy and other muscle disorders resulting from statin therapy “will continue to be a concern to patients and a diagnosis elusive to physicians. This debilitating adverse effect underscores the importance of prescribing statins only to patients who will clearly have a net benefit.”

Caughey and Curfman have disclosed no relevant financial relationships.

JAMA Intern Med. Abstract, Editor’s note

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Cite this article: Statin Use Linked to Idiopathic Inflammatory Myositis – Medscape – Jul 31, 2018.

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Funds will help further research into regenerative joint replacement and improve health care – May 05, 2016

COLUMBIA, Mo. – The Thompson Foundation, created by William and Nancy Thompson, has pledged $3 million to the University of Missouri School of Medicine to create the Thompson Lab for Regenerative Orthopaedics. Researchers at the new lab will pursue discoveries and advances to help people with joint replacements resume family and work activities sooner and lower costs and improve access to health care. By training at the new center, surgeons and researchers will be able to spread the world-class regenerative orthopedic programs and technologies developed at the MU School of Medicine across the nation and around the globe to benefit millions of people.

“The Thompsons’ generosity and continued support for Mizzou are inspirations to the entire MU community,” MU Interim Chancellor Hank Foley said. “This gift will allow MU to further advance us as a world leader in regenerative orthopedics. This gift directly supports our primary missions of discovery and improving the health of Missourians and the world. With strong support such as this, MU will play a leading role in the future of health care.”

The new lab will be housed on the fourth floor of the new addition to the Missouri Orthopaedic Institute, which is currently under construction. Recent research into regenerative orthopedics at MU includes the development of a better method to store donor tissue, and improved procedures for repairing torn knee ligaments and other joint injuries. James Cook, the William and Kathryn Allen Distinguished Professor of Orthopaedic Surgery and director of the Orthopaedic Research Division at MU, says this gift will create a unique opportunity to provide world-class care for Missourians.

“This amazing gift will create a center of discovery, translational and transformative research, and clinical applications,” Cook said. “It will set Mizzou apart in this burgeoning area of medicine. Because the Thompsons have provided this incredibly unique opportunity for us to create a world-class laboratory right in the heart of our clinical orthopedic center, we will be able to more efficiently and effectively improve health care.”

“Since our days at Mizzou, Nancy and I have been fortunate to meet some of the exceptional academic, medical and research talent within the University,” Bill Thompson said. “When Drs. Hal Williamson, Jim Stannard and Jimi Cook told us of their exciting plans for future discovery and innovative treatment in regenerative orthopedics, we jumped at the chance to invest in their cutting-edge work! It has the potential to benefit the lives of countless people, young and old.”

“We cannot thank the Thompsons enough for their generosity and vision to support such life-changing research here at MU,” said Patrick Delafontaine, dean of the MU School of Medicine. “Our faculty and students are doing amazing things at the Missouri Orthopaedic Institute and with regenerative orthopedics in particular. This financial support will have a tremendous impact on health care and improving the quality of life for Missourians and people around the world.”

“MU Health Care is devoted to improving the lives and health of all Missourians,” Mitch Wasden, chief executive officer of MU Health Care said. “This amazing gift will further this mission and ultimately have significant positive effects on the health and well-being of people throughout our state and beyond. From our entire team of more than 6,000 clinicians, scientists, educators and health professionals, I sincerely thank the Thompsons for their generous support.”

With an overall fundraising goal of $1.3 billion, the Mizzou: Our Time to Lead campaign will secure the University of Missouri’s status among the nation’s elite public universities by focusing on three priorities: endowment — building the university’s endowment to compete with other institutions will strengthen the ability to attract and retain stellar students and faculty; signature centers and institutes — interdisciplinary centers and institutes will be the engine of research growth that will enhance MU’s AAU status and add to the university’s distinctiveness; and a campus renaissance — new and renovated facilities will propel Mizzou to global leadership in education and research and will help attract and retain students and faculty.

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“Both authoritative and patient-focused, Metabolic Therapies in Orthopedics, 2^nd Edition gives health care practitioner’s a solid hook on which to confidently hang their stethoscope, figuratively speaking. It’s practical, written by clinicians for clinicians. These clinicians “walk the talk,” providing empowerment by teaching effective, safe and valuable practice guidelines. Their work serves the interest of important constituencies of the healthcare system, patients, families, providers, and the community.  It’s a practical tool that allows you to translate its contents into a realistic medical practice.”

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