Dead Meat: Glecaprevir/Pibrentasvir-Induced Statin Myonecrosis

Excerpt

A 60-year-old male with a past medical history of compensated, Child–Pugh class A cirrhosis due to chronic hepatitis C virus (HCV) infection and coronary artery disease who had been taking simvastatin 20 mg daily since 2008 was started on glecaprevir–pibrentasvir (Mavyret) 6 weeks prior to presentation. He initially complained of muscle weakness and myalgias for 2 weeks and jaundice for 2 days. Additional past medical history included chronic kidney disease stage IIIa secondary to hypertension, moderate chronic obstructive pulmonary disease from long-term nicotine abuse, atrial fibrillation, systolic heart failure with reduced ejection fraction status post-implantable cardio-defibrillator device, and coronary artery disease status post-coronary artery bypass grafting in 2010. …