Background/Purpose: Premature atherosclerotic coronary artery disease is a major source of morbidity for women with systemic lupus erythematosus (SLE).  Lipid lowering medications (LLM) are among the most commonly prescribed medications used to reduce cardiovascular risk.  However, LLM use may be complicated by muscle symptoms, including weakness.  This study examines the relationship between LLM use and muscle strength in women with SLE.

Methods: Subjects were participants in a longitudinal cohort with documented SLE.  All measures were collected during an in-person research visit among a subset of the cohort.  Only women were included in the analysis.  LLM use was assessed by asking participants, “Do you have or are you being treated for high cholesterol? If yes, are you taking any prescription medicines for it?” Which specific LLM participants were taking was not assessed.  Lower extremity muscle strength was assessed by knee torque and chair-stand time. A Biodex® unit was used to measure peak torques of knee extension and flexion at 150 degrees/second adjusted for body weight.  Chair-stand time was measured as the time to complete 5 chair-stands from a standard chair without using one’s arms.   Mean knee torque and chair-stand time were compared between participants taking and not taking a LLM using Student’s t-test.  Regression analyses controlling for age, SLE duration, prednisone use, and SLE disease activity measured with the Systemic Lupus Activity Questionnaire (SLAQ) modeled the effect of LLM use on lower extremity muscle strength and chair stand time. 

Results: Twenty-nine of 137 women (21%) reported taking a LLM. Mean age was 48 (±12) years; duration of SLE was 16 (±9) years. Women taking a LLM, compared to women not taking a LLM, had significantly lower strength on knee extension (mean peak torque 19 [±13] vs 29 [±15] foot-pounds, p=0.001) and on knee flexion (mean peak torque 14 [±9] vs 21 [±11] foot-pounds, p=0.002).  Mean chair-stand time was greater for women taking a LLM than women not taking a LLM: 23 (±9) and 18 (±8) seconds (p=0.004). The results did not substantively change after adjusting for the effect of age, SLE duration, prednisone use, and SLAQ score.

Conclusion: Women with SLE who take a LLM, compared to women who do not, demonstrated decreased muscle strength on two objective assessments of lower extremity strength.  Additional studies are needed to further characterize the association between LLM use and reduced muscle strength among women with SLE.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/lipid-lowering-medication-use-is-associated-with-reduced-muscle-strength-in-systemic-lupus-erythematosus/