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To the Editor: In their study on rhabdomyolysis in patients treated with lipid-lowering drugs, Dr Graham and colleagues¹ reported that, compared with statin monotherapy, the use of fibrates alone was associated with a 5.5-fold increase in the risk of rhabdomyolysis requiring hospitalization and the combined use of a statin and fibrate resulted in an additional increase in this risk, especially in older patients with diabetes mellitus. These risks were most pronounced for cerivastatin compared with other statins, both when it was used as monotherapy and when used in combination with a fibrate.

The study also found a significant dissimilarity between gemfibrozil (3 cases of rhabdomyolysis with monotherapy and 4 cases in combination with a statin) and fenofibrate (0 cases of rhabdomyolysis with monotherapy and 1 case in combination with atorvastatin). Several studies have found that fenofibrate and bezafibrate might be significantly safer than gemfibrozil.^2-5 Moreover, combining a fibrate with a . . . [Full Text of this Article]

Alexander Tenenbaum, MD, PhD
altenen@post.tau.ac.il

Enrique Z. Fisman, MD; Michael Motro, MD
Cardiac Rehabilitation Institute
Chaim Sheba Medical Center
Tel-Hashomet, Israel

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