Rhabdomyolysis and acute neuromyopathy associated with the combined use of statin and colchicine: A case report and a review of the literature. Issue 1 (January 2019) - Liuzzi, D.
Abstract : To report a case of colchicine-induced rhabdomyolysis and neuromyopathy in a patient treated with atorvastatin and colchicine and to review the literature about this topic. A 69-year-old man affected by diabetes mellitus and chronic renal insufficiency was prescribed atorvastatin, after that an ischemic stroke occurred, with no side effect. After 2 months colchicine (0.5 mg three times a day) was added to treat pericarditis and six weeks later, the patient began to experience increasing symmetrical proximal muscle weakness which was worse in the legs. Laboratory results suggested rhabdomyolysis, while physical examination and electromyography findings were consistent with neuromyopathy. One month after the discontinuation of colchicine and atorvastatin, the patient weakness improved and muscle enzymes levels returned to normal levels. Eleven patients with clinical and laboratory characteristics similar to our patient's caused by the combined use of colchicine and statins have been previously described in literature. Both colchicine and statin therapy may be associated with myopathy. Co-administration may exacerbate the myotoxicity because both drugs metabolism depend on hepatic demethylation through CYP450 3A4. Combination therapy with colchicine and statin should be avoided because of the risk of developing myopathy and rhabdomyolysis even after a long uneventful statin or colchicine medication.