Incidence of elevated creatine phosphokinase between daptomycin alone and concomitant daptomycin and statins: A systematic review and meta-analysis

Masaru Samura, Keisuke Takada, Naoki Hirose, Takenori Kurata, Fumio Nagumo, Sakura Koshioka, Junichi Ishii, Masaki Uchida, Junki Inoue, Yuki Enoki, Kazuaki Taguchi, Koji Tanikawa, Kazuaki Matsumoto

Research output: Contribution to journalReview articlepeer-review

Abstract

Aims: The present systematic review and meta-analysis evaluated the incidence of elevated creatine phosphokinase (CPK) levels between daptomycin alone and concomitant daptomycin and statin use. Methods: We searched the PubMed, Web of Sciences, Cochrane Library and ClinicalTrials.gov databases. We analysed the incidence of elevated CPK between daptomycin alone and concomitant daptomycin and statins among studies defining CPK elevation as levels ≥ the upper limit of normal (ULN) or ≥5× ULN. We also analysed the incidence of rhabdomyolysis between the groups. We then calculated the odds ratios (ORs) and 95% confidence intervals (CIs) based on the included studies. Results: Comparing CPK elevation defined as CPK levels ≥ULN, a significantly higher incidence of CPK elevation was observed with concomitant daptomycin and statin use than with daptomycin alone (OR = 2.55, 95% CI 1.78–3.64, P <.00001, I2 = 0%). Likewise, when CPK elevation was defined as CPK levels ≥5× ULN, a significantly higher incidence of CPK elevation was detected with concomitant daptomycin and statin use than with daptomycin alone (OR = 1.89, 95% CI 1.06–3.35, P =.03, I2 = 48%). The incidence of rhabdomyolysis was significantly higher following concomitant daptomycin and statin use than with daptomycin alone (OR = 11.60, 95% CI 1.81–74.37, P =.01, I2 = 0%). Conclusion: The combined use of daptomycin and statins were significant risk factors for the incidence of CPK elevation defined as levels ≥ULN or ≥5× ULN and rhabdomyolysis.

Original languageEnglish
Pages (from-to)1985-1998
Number of pages14
JournalBritish journal of clinical pharmacology
Volume88
Issue number5
DOIs
Publication statusPublished - 2022 May

Keywords

  • concomitant use
  • creatine phosphokinase elevation
  • daptomycin
  • meta-analysis
  • statin

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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