{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:00:00Z","timestamp":1785373200003,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantify how often creatine kinase (CK) is measured after newly elevated aminotransferases in statin users, and whether absent CK data are associated with gastroenterology (GI) referrals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective chart review of adult outpatients on statins with a first alanine\/aspartate aminotransferase (ALT\/AST) elevation during a 5\u2010year period at a large health system. The primary outcome was CK testing within 30\u2009days; secondary outcomes included CK elevation rate and GI referral within 60\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 806 eligible patients, 22.8% (184\/806) had CK measured within 30\u2009days (median 9\u00a0days; IQR 5\u201317). Of those tested, 15.8% (29\/184) had CK above the upper limit of normal (ULN); 3.6% (29\/806) of the entire cohort therefore had unrecognized biochemical evidence of muscle injury. None had documented rhabdomyolysis, acute kidney injury or hospitalization. Among patients without timely CK testing (619\/806), 4.7% (29\/619) were referred to GI within 60\u2009days; this proportion (3.6% of the total cohort) mirrored the fraction with CK elevation, suggesting potentially avoidable hepatic work\u2010ups in the absence of muscle\u2010specific testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In routine practice, CK is infrequently measured after new ALT\/AST elevations in statin users, yet a non\u2010trivial subset has biochemical myopathy. Reflex CK testing at the first abnormal transaminase could improve diagnostic accuracy and reduce unnecessary GI referrals while preserving effective lipid\u2010lowering therapy. Prospective evaluation of reflex\u2010testing pathways and tailored statin selection\/dosing is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70581","type":"journal-article","created":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:14:31Z","timestamp":1777850071000},"page":"2917-2923","source":"Crossref","is-referenced-by-count":0,"title":["Patients on statins with elevated transaminases: Frequency of follow\u2010up creatine kinase testing and gastroenterology referral"],"prefix":"10.1002","volume":"92","author":[{"given":"Faris","family":"Shweikeh","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic Akron General  Akron Ohio USA"},{"name":"Department of Internal Medicine MLK Community Hospital\/UCLA David Geffen SOM  Los Angeles California 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