Posible rotura tendinosa espontánea relacionada con el uso de atorvastatina / Possible spontaneous tendon rupture related to the use of atorvastatin

La rotura espontánea del tendón cuadricipital (REC) es una lesión de escasa incidencia cuya etiología se ha relacionado con el uso de diferentes fármacos. Las estatinas son fármacos que se han asociado a la aparición de reacciones adversas que afectan al sistema músculo-esquelético, aunque la relación entre su uso y las roturas tendinosas es controvertida. Presentamos 2 casos de REC de pacientes en tratamiento con atorvastatina. Este trabajo contribuye a aumentar la literatura publicada sobre la posible asociación entre el uso de atorvastatina y la aparición de REC

Spontaneous quadriceps tendon rupture (SQTR) is a lesion of low incidence whose etiology has been related to the use of different drugs. Statins have been associated with the appearance of adverse reactions that affect the musculoskeletal system. However, the relationship between their use and tendon rupture remains controversial. We present 2 cases of SQTR in patients taking atorvastatin. This work contributes to increase the published literature of the association between use of atorvastatin and appearance of SQTR

Venous thromboembolism in patients with advanced cancer under palliative care: additional risk factors, primary/secondary prophylaxis and complications observed under normal clinical practice.

We analyzed the principal risk factors of venous thromboembolism (VTE) (immobilization, recent surgery and previous VTE), prophylaxis with low-molecular weight heparin (LMWH) and complications (i.e. severe bleeding, recurrence and death). Patients with advanced cancer under palliative care (PC) and with VTE, were reviewed during the three years before the study. 71 Patients were diagnosed with VTE. 88.7% were outpatients. The risk factors present were: immobilizations in 28 patients (39.4%), recent surgery in 5 (7%) and previous VTE in 23 (32.5%). Prophylaxis was used in 4 (14.3%) patients with immobilization, no patient with recent surgery, and 10 (43.4%) patients with previous VTE. After diagnosis, all patients received treatment with LMWH in therapeutic dosage. The complications observed were: 6 recurrences (8.5%), 11 VTE-related deaths (15.5%), and bleeding events occured in 8 cases (11.3%), 4 (5.6%) of whom suffered severe bleeding; of these patients, 3 (4.2%) died as a result of the bleeding events. In PC patients with advanced cancer, VTE is a serious complication that conditions control of symptoms. The presence of other risk factors, immobilization and previous VTE, is common and LMWH prophylaxis is limited in clinical practice. The risks vs benefits of anticoagulation need to be counterbalanced.