ICD-9 codes underestimate statin-linked rhabdomyolysis

April 18, 2012
<i>ICD-9</i> codes underestimate statin-Linked rhabdomyolysis

(HealthDay) -- Use of diagnostic codes, such as International Classification of Diseases -- Ninth Revision (ICD-9) codes, may result in misclassification of rare, adverse drug reactions (ADRs), including the risk of rhabdomyolysis from high-dose simvastatin, according to a research letter published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

To assess the use of diagnostic codes as a method of estimating statin-related rhabdomyolysis and myopathy, James S. Floyd, M.D., of the University of Washington in Seattle, and colleagues reviewed the full for patients from the Group Health Cooperative who had a statin prescription within three months of an ICD-9 code for rhabdomyolysis or an ADR.

The researchers found that among the 292 statin users with an ICD-9 code for rhabdomyolysis, 29 cases were identified and validated. None of the 29 cases died; 90 percent were hospitalized and 29 percent had at least a doubling of serum creatinine levels. Using the ICD-9 code, the rhabdomyolysis incidence rate ratio (IRR) for simvastatin versus other statins was 2.61 versus 1.03. For a dose of simvastatin of 80 mg per day or greater versus 20 to 39 mg per day, the IRR was 12.2 for validated cases and 1.77 using the ICD-9 code for rhabdomyolysis.

"These results confirm in a community setting findings from a recent clinical trial that prompted the U.S. to issue a warning about the use of high-dose simvastatin," the authors write. "The ICD-9 code for rhabdomyolysis was nonspecific for this ADR, and the resulting misclassification markedly attenuated the estimated relative risk for high-dose versus low-dose simvastatin."

One of the authors disclosed to the medical device/technology industries.

Explore further: FDA announces new limits on high-dose simvastatin (Zocor)

More information: Abstract
Full Text (subscription or payment may be required)

Related Stories

FDA announces new limits on high-dose simvastatin (Zocor)

June 9, 2011
The United States Food and Drug Administration (FDA) today announced new limitations to the use of high-dose simvastatin, due to the increased risk of muscle pain and weakness (myopathy) and in rare cases, kidney damage and ...

Intensive-dose statin therapy associated with increased risk of diabetes

June 21, 2011
An analysis of data from previously published studies indicates that intensive-dose statin therapy is associated with an increased risk of new-onset diabetes compared with moderate-dose therapy, according to a study in the ...

Early clinical data show galeterone safe, effective against prostate cancer

April 1, 2012
Patients with castration-resistant prostate cancer had limited side effects and in many cases a drop in prostate-specific antigen expression with galeterone (TOK-001), a small-molecule oral drug, according to phase I data ...

Recommended for you

Drug for spinal muscular atrophy prompts ethical dilemmas, bioethicists say

December 11, 2017
When the Food and Drug Administration approved the first drug for people with spinal muscular atrophy a year ago, clinicians finally had hope for improving the lives of patients with the rare debilitating muscular disease. ...

FDA's program to speed up drug approval shaved nearly a year off the process

December 7, 2017
Speeding the pace at which potentially lifesaving drugs are brought to market was a rallying cry for Donald Trump as a candidate, and is a stated priority of his Food and Drug Administration commissioner, Dr. Scott Gottlieb. ...

Dangers of commonly prescribed painkillers highlighted in study

December 6, 2017
Commonly prescribed painkillers need to be given for shorter periods of time to reduce the risk of obesity and sleep deprivation, a new study has revealed.

Viagra goes generic: Pfizer to launch own little white pill

December 6, 2017
The little blue pill that's helped millions of men in the bedroom is turning white. Drugmaker Pfizer is launching its own cheaper generic version of Viagra rather than lose most sales when the impotence pill gets its first ...

Surgery-related opioid doses can drop dramatically without affecting patients' pain

December 6, 2017
Some surgeons might be able to prescribe a third of opioid painkiller pills that they currently give patients, and not affect their level of post-surgery pain control, a new study suggests.

Four-fold jump in deaths in opioid-driven hospitalizations

December 4, 2017
People who end up in the hospital due to an opioid-related condition are four times more likely to die now than they were in 2000, according to research led by Harvard Medical School and published in the December issue of ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.