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Statin Adverse ReactionNCT07511686

Metabolic and Mitochondrial Changes in Statin-Induced Myopathy

An observational study of Statin Adverse Reaction and Statin-induced Myopathy, run by Riga Stradins University at 1 site in Latvia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this observational study is to learn whether statin-related muscle symptoms are linked to problems in fat metabolism in muscle cells, specifically involving acylcarnitines, in adults taking or not taking statins. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Blood sampling and laboratory assessment and Muscle biopsy
How many people
38 participants
Where
1 siteLatvia
Study dates
22 Aug 2023to 9 Oct 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The study population consists of adult participants (≥18 years) of Caucasian ethnicity recruited at the Latvian Cardiology Center of Pauls Stradiņš Clinical University Hospital. The study includes three groups: (1) patients with elevated creatine kinase levels with or without muscle symptoms suggestive of statin-associated muscle myopathy, (2) patients receiving stable high-dose statin therapy without muscle symptoms, and (3) individuals not receiving lipid-lowering therapy and without unexplained muscle symptoms. Participants may be hospitalized patients or outpatients, including referrals from other medical institutions. All participants must provide written informed consent, and a subset of participants may additionally consent to undergo muscle biopsy for further analysis of mitochondrial metabolism in muscle tissue.

Who may be able to join

  • Age at least 18 years.
  • A representative of the Caucasian race.
  • The patient agrees to participate in the study by signing an informed consent form for participation in the study. (The patient may only be included in the muscle biopsy sub-study if the relevant additional informed consent form has also been signed.)
  • Specific inclusion criteria for each of the study subgroups:
  • Group A: patients have elevated creatine kinase levels >1.5x above the upper limit of normal (women >325 U/L and men >504 U/L) with or without muscle symptoms that have no other obvious explanation (including intense physical activity in the last 7 days).
  • Group B: atorvastatin 40-80 mg or rosuvastatin 20-40 mg monotherapy for at least 8 weeks at a constant dose and no muscle symptoms (pain, weakness, fatigue, cramps) during this period, CK <200 U/L.
  • Group C: no lipid-lowering agents have been used during the last year and there have been no muscle symptoms (pain, weakness, fatigue, cramps) of unknown origin lasting >1 week during this period, CK <200 U/L.

Who cannot join

  • Any disease that, in the opinion of the investigator, could also cause a significant increase in CK or muscle symptoms.
  • Use of other cholesterol-lowering agents specific to each of the study groups:
  • Group A: use of red yeast rice extract, fibrates, or bempedoic acid within the last 8 weeks.
  • Group B: use of other non-statin cholesterol-lowering agents (red yeast rice extract, ezetimibe, fibrates, PCSK9 inhibitors, inclisiran, bempedoic acid) in the last 8 weeks.
  • Group C: use of any cholesterol-lowering agents (statins, red yeast rice extract, ezetimibe, fibrates, PCSK9 inhibitors, inclisiran, bempedoic acid) in the last 12 weeks.
  • Intense physical activity in the last 7 days.
Show all 12Show fewer
  • Acute myocardial infarction or stroke in the last 4 weeks.
  • Major surgery within the last 4 weeks (invasive cardiac procedures are not an exclusion criterion).
  • Patients with severe illness that, in the investigator's opinion, may significantly affect the patient's overall metabolism (e.g., active malignancy, terminal heart failure, etc.).
  • Excessive alcohol consumption (binge drinking or >7 units of alcohol per day) within the last year.
  • Use of other substances or medications known to have direct myotoxic effects (e.g., fibrates, cyclosporins, labetalol, propofol, procainamide, interferon-alpha, hydroxyurea, zidovudine, colchicine, vincristine, amiodarone, corticosteroids) or that may affect CK elevation.
  • Use of meldonium within the last 2 months.

Trial locations and contacts

1 site in 1 country.

Latvia1 site
  • University of Latvia (Faculty of Medicine and Institute of Cardiology and Regenerative Medicine)

    Riga

Other trials in Latvia

About this study

Official title: Measurement of Acylcarnitine Levels and Mitochondrial Functionality in Connection With Statin-Induced Skeletal Muscle Myopathy

The goal of this observational study is to learn whether statin-related muscle symptoms are linked to problems in fat metabolism in muscle cells, specifically involving acylcarnitines, in adults taking or not taking statins. The main questions it aims to answer are:

Do patients with statin-associated muscle symptoms have higher acylcarnitine levels in blood and muscle compared to statin users without symptoms and people not taking statins? Do acylcarnitine levels decrease after stopping or reducing statin treatment in affected patients?

Read more

Researchers will compare patients with statin-associated muscle symptoms, statin users without symptoms, and individuals not taking statins to see if differences in acylcarnitine levels and muscle metabolism are associated with muscle symptoms.

Participants will:

Provide blood samples for biochemical tests and acylcarnitine analysis Share information about their health, medications, and lifestyle (Optional) undergo a muscle biopsy to study muscle metabolism Some participants with muscle symptoms will have repeat blood tests and possibly a repeat muscle biopsy after statin dose reduction or discontinuation to track changes over time

Read the detailed description

Statins are widely used lipid-lowering medications that reduce cardiovascular risk, but their use may be limited by statin-associated muscle symptoms (SAMS), which range from mild myalgia to significant elevations in creatine kinase (CK). The underlying biological mechanisms of SAMS are not fully understood. One proposed mechanism involves impaired mitochondrial fatty acid metabolism, which may lead to the accumulation of acylcarnitines-intermediate metabolites involved in fatty acid transport and oxidation within mitochondria.

This study aims to investigate whether statin-associated muscle symptoms are associated with disturbances in acylcarnitine metabolism in blood and skeletal muscle tissue. Specifically, the study will assess whether patients with SAMS have higher concentrations of acylcarnitines compared to statin users without muscle symptoms and individuals not receiving statin therapy, and whether these concentrations change after discontinuation or reduction of statin therapy.

This is a single-center observational case-control study conducted at the Latvian Cardiology Center of Pauls Stradiņš Clinical University Hospital. The study population includes three groups: (1) patients with elevated CK levels with or without muscle symptoms suggestive of statin-associated myopathy, (2) patients receiving stable high-dose statin therapy without muscle symptoms, and (3) control participants not using lipid-lowering therapy and without unexplained muscle symptoms.

All participants underwent a single study visit during which demographic data, medical history, medication use (including statins and other lipid-lowering therapies), and lifestyle factors (such as smoking, alcohol consumption, and physical activity) were recorded. Blood samples were collected for routine biochemical analyses (including CK, alanine aminotransferase, creatinine, and lipid profile) and for the measurement of plasma acylcarnitine concentrations. Plasma samples were processed and stored at -80°C for current and future analyses.

Participants were assessed for statin-associated muscle symptoms using the Statin-Associated Muscle Symptom Clinical Index (SAMS-CI). In a subset of participants who provided additional informed consent, a muscle biopsy was performed under local anesthesia from the non-dominant forearm muscle. Muscle tissue samples were used to evaluate acylcarnitine concentrations and mitochondrial fatty acid metabolism.

Participants in the SAMS group (Group A) who required discontinuation or dose reduction of statin therapy as part of routine clinical care underwent prospective follow-up. Repeat blood sampling was performed approximately 4 and 8 weeks after statin discontinuation or dose adjustment, and continued at 4-week intervals (up to 24 weeks) until CK levels normalized. In selected participants, a repeat muscle biopsy was performed within 4-8 weeks after statin discontinuation or dose reduction to assess changes in mitochondrial metabolism and acylcarnitine concentrations.

Data will be analyzed to compare acylcarnitine concentrations between groups and to evaluate changes over time in the SAMS group. Quantitative variables will be summarized using means and standard deviations or medians and interquartile ranges, depending on data distribution. Between-group comparisons will be performed using parametric or non-parametric statistical tests as appropriate, and repeated measurements will be analyzed using paired statistical methods. A p-value <0.05 will be considered statistically significant.

The results of this study are expected to improve understanding of the pathophysiology of statin-associated muscle symptoms and may contribute to the development of better diagnostic and management strategies for patients experiencing statin intolerance.

Being tested
Blood sampling and laboratory assessment, Muscle biopsy
Keywords
statins, myopathy, statin-induced myopathy, acylcarnitines
Medical subject headings
Muscular Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood sampling and laboratory assessmentOther

    Collection of blood samples for measurement of acylcarnitine concentrations and routine biochemistry, including creatine kinase and lipid profile.

  • Muscle biopsyOther

    Optional muscle tissue sampling under local anesthesia from the non-dominant forearm muscle for assessment of acylcarnitine concentrations and mitochondrial fatty acid metabolism.

Study groups in NCT07511686
Study groupRoleWhat they receive
Group A: Statin-Associated Muscle Symptoms (SAM)Adults with elevated creatine kinase (CK >1.5× upper limit of normal) with or without muscle symptoms that cannot be explained by other causes. Participants may continue using statins or may require statin discontinuation or dose reduction.
Receives: Other: Blood sampling and laboratory assessment; Other: Muscle biopsy
Group B: Statin Users Without Muscle SymptomsAdults receiving stable high-dose statin monotherapy (atorvastatin 40-80 mg or rosuvastatin 20-40 mg) for at least 8 weeks, without muscle symptoms and with normal CK levels (<200 U/L).
Receives: Other: Blood sampling and laboratory assessment; Other: Muscle biopsy
Group C: Control Group (No Statin Use)Adults who have not used any lipid-lowering therapy in the past year, have no unexplained muscle symptoms, and have normal CK levels (<200 U/L).
Receives: Other: Blood sampling and laboratory assessment; Other: Muscle biopsy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Acylcarnitine concentrations in blood

    Comparison of plasma acylcarnitine levels between patients with statin-associated muscle symptoms, statin users without symptoms, and controls not using statins.

    Measured: At baseline (single visit)

  2. Acylcarnitine concentrations in muscle tissue

    Comparison of acylcarnitine levels in muscle biopsy samples between study groups to assess differences in mitochondrial fatty acid metabolism.

    Measured: At baseline (muscle biopsy visit)

Secondary outcomes (2)
  1. Changes in acylcarnitine concentrations after statin discontinuation or dose reduction

    Evaluation of changes in plasma acylcarnitine levels in patients with statin-associated muscle symptoms after stopping or reducing statin therapy.

    Measured: Approximately 4 weeks and 8 weeks after statin discontinuation or dose reduction (up to 24 weeks if needed)

  2. Changes in muscle acylcarnitine concentrations (subset of participants)

    Evaluation of changes in muscle acylcarnitine levels in patients undergoing repeat muscle biopsy after statin discontinuation or dose reduction.

    Measured: 4-8 weeks after statin discontinuation or dose reduction (up to 24 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Apr 2026
  2. Study start22 Aug 2023
  3. Primary completion9 Oct 2024
  4. Study completion9 Oct 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
38 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07511686
Sponsor's protocol ID
VPP-EM-BIOMEDICĪNA-2022/1-0001
Status last verified
Mar 2026
First submitted
30 Mar 2026
Last updated
6 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: We will deposit individual original measurement results, but not anthropometric data.

Questions about this trial

What is this clinical trial studying?

An observational study of Statin Adverse Reaction and Statin-induced Myopathy, run by Riga Stradins University at 1 site in Latvia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 6 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Latvia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Acylcarnitine concentrations in blood (time frame: At baseline (single visit)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Apr 2026.

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