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Evidence to Improve Care

Creatine Kinase Testing


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends that creatine kinase be removed from the Ontario laboratory requisition form.

  • Given the uncertainty regarding rhabdomyolysis (muscle breakdown) caused by statins, it is recommended that this be explored further through a field evaluation using existing administrative datasets by the Institute for Clinical Evaluative Sciences (ICES).

Note: further recommendations on the appropriate testing parameters for creatine kinase may be added after the field evaluation has been completed.

Read the full OHTAC Recommendation report



People with high cholesterol often take a type of drug called a statin to lower their cholesterol levels. However, there have been reports of muscle aches, soreness, or weakness (called rhabdomyolysis) associated with high levels of creatine kinase in people who take statin drugs. Creatine kinase is an enzyme (a protein) found in the brain, muscles and heart and can be a sign of muscle damage.


Health Quality Ontario Reviews Creatine Kinase Testing

Health Quality Ontario talked to experts to find out whether testing creatine kinase levels in people who take statins is helpful.


Creatine Kinase Measurement for Patients on Statins: A Rapid Review (PDF)
December 2012


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The Ministry of Health and Long-Term Care has accepted this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The creatine kinase test was removed from the laboratory requisition in April 2013.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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