Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY 40213, USA.
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
J Clin Lipidol. 2014 May-Jun;8(3 Suppl):S47-57. doi: 10.1016/j.jacl.2014.02.011.
In the 2006 Report of the National Lipid Association's Statin Safety Task Force, a panel of experts in hepatology published their findings on specific questions related to the liver blood testing during statin therapy. Among their recommendations was that regulatory agencies reconsider the statin-labeling recommendation at that time, which required post-statin liver enzyme testing. Since then, the Food and Drug Administration altered statin labeling such that unless clinically indicated for other reasons, after a pre-statin therapy baseline evaluation, follow-up liver enzyme testing was not uniformly required after statin initiation. This 2014 report provides an update on interim issues relevant to statins and liver safety. Some of the points discussed include the value of baseline liver enzymes before initiating statin therapy, safety of statin use in patients with nonalcoholic fatty liver disease, potential drug interactions between statins and drugs used to treat hepatitis, the use of statins in liver transplant recipients, and the use of statins in patients with autoimmune liver disease. Finally, this panel provides diagnostic and algorithmic approaches when evaluating statin-treated patients who experience elevations in liver enzymes.
在 2006 年国家脂类协会他汀类药物安全性工作组的报告中，一组肝脏病学专家就他汀类药物治疗期间肝脏血液检测的具体问题发布了他们的研究结果。他们的建议之一是，监管机构重新考虑当时他汀类药物标签的建议，当时的建议要求在他汀类药物治疗后进行肝酶检测。此后，美国食品和药物管理局改变了他汀类药物的标签，除非出于其他临床原因，否则在他汀类药物治疗前基线评估后，他汀类药物起始后不需要常规进行肝酶检测。本 2014 年报告提供了与他汀类药物和肝脏安全性相关的最新中期问题。讨论的要点包括在开始他汀类药物治疗前检测基础肝酶的价值、非酒精性脂肪性肝病患者使用他汀类药物的安全性、他汀类药物与用于治疗肝炎的药物之间的潜在药物相互作用、肝移植受者使用他汀类药物以及自身免疫性肝病患者使用他汀类药物的问题。最后，本专家组提供了在评估经历肝酶升高的他汀类药物治疗患者时的诊断和算法方法。
