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氟伐他汀:临床与安全性概况。

Fluvastatin: clinical and safety profile.

作者信息

Corsini Alberto, Jacobson Terry A, Ballantyne Christie M

机构信息

University of Milan, Milan, Italy.

出版信息

Drugs. 2004;64(12):1305-23. doi: 10.2165/00003495-200464120-00004.

Abstract

Therapy with HMG-CoA reductase inhibitors (statins) has been shown to significantly reduce major coronary events and death in a wide range of individuals at risk for these events. In addition, recent observations suggest that some of the clinical benefits associated with statin therapy may be pleiotropic; that is, independent of their cholesterol-inhibiting action. It is clear that the clinical benefits associated with statin therapy far outweigh the risks; however, there may be important clinical differences among agents within the class, related to both benefits and drug safety. Evaluation of the benefit-to-risk profile for each available statin should include considering the results of randomised clinical outcome trials, the safety record of each agent, effect on lipoproteins and evidence of beneficial pleiotropic properties.Recently, data from several clinical outcome trials have shown that substantial benefits are associated with treatment with fluvastatin in diverse populations. In particular, data from two large, randomised clinical trials have demonstrated that fluvastatin is effective for secondary prevention of cardiac events in patients following coronary intervention procedures, and for primary prevention of cardiac events in renal transplant recipients. Pleiotropic benefits for fluvastatin have been shown in experimental and clinical studies as well. Fluvastatin was the first statin available as an extended-release product (fluvastatin XL 80mg); both formulations have demonstrated efficacy and safety in a wide range of patients. Taken together, these clinical outcomes and safety data suggest a strong benefit-to-risk profile for fluvastatin.

摘要

HMG-CoA还原酶抑制剂(他汀类药物)治疗已被证明可显著降低各类有此类事件风险个体的主要冠状动脉事件和死亡风险。此外,最近的观察结果表明,他汀类药物治疗带来的一些临床益处可能具有多效性;也就是说,独立于其抑制胆固醇的作用。显然,他汀类药物治疗带来的临床益处远远超过风险;然而,该类药物中的不同药物在临床方面可能存在重要差异,这与益处和药物安全性都有关。评估每种可用他汀类药物的风险效益比应包括考虑随机临床结局试验的结果、每种药物的安全记录、对脂蛋白的影响以及有益多效性特性的证据。最近,多项临床结局试验的数据表明,氟伐他汀治疗在不同人群中都有显著益处。特别是,两项大型随机临床试验的数据表明,氟伐他汀对冠状动脉介入治疗后患者的心脏事件二级预防以及肾移植受者的心脏事件一级预防有效。氟伐他汀的多效性益处也已在实验和临床研究中得到证实。氟伐他汀是首个有缓释产品(氟伐他汀XL 80mg)的他汀类药物;两种剂型在广泛患者中均已证明有效且安全。综合来看,这些临床结局和安全性数据表明氟伐他汀具有很强的风险效益比。

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