Jose Jimmy, Al-Tamimi Faisal Abdullah Ali, Helal Manal Mahmoud, Jimmy Beena, Al Riyami Qasim
Assistant Dean (Research) and Associate Professor, School of Pharmacy, College of Pharmacy and Nursing, University of Nizwa,P.B No 33, PO 616, Birkat Al Mouz, Nizwa, Sultanate of Oman.
Senior Consultant, Physician & Rheumatologist, Department of Medicine, Nizwa Hospital, Ministry of Health, Sultanate of Oman.
Oman Med J. 2014 Sep;29(5):351-7. doi: 10.5001/omj.2014.93.
This study aimed at evaluating the prevalence, pattern and predisposing factors for hepatic adverse effects with statins in a regional hospital in Sultanate of Oman.
A retrospective review of the patient files in Department of Medicine during the year 2011 was done to evaluate any hepatic dysfunction possibly related to statins among the patients. For each case of suspected statin induced hepatic effect, additional details on temporal relationship, pattern of presentation, management, final outcome and any contributing factors were obtained. Difference in the occurrence of hepatic effects based on the patient demographics and drug characteristics was additionally evaluated.
A total of 927 patients meeting the inclusion criteria were included for the study. Mean age of the evaluated patients was 63.1 ± 11.37 and median duration of use of statin in months was 22 (IQR, 43.25). In 40 (4%) of the 927 patients, there was presence of a hepatic effect considered to be statin related and only in 12 (1%) patients a significant transaminase rise (>3 times) was observed. Median duration of use of statin among those patients who developed suspected statin induced hepatic effects and those who did not was 45 (IQR,52) and 21 (IQR, 43) months, respectively and the difference observed was statistically significant. A significant difference in the prevalence of hepatic effects was observed only based on the duration of statin use.
There was an infrequent occurrence of significant hepatic effects associated with statins in the study population. Our results support the latest recommendations including from United States Federal Drug Administration (US FDA) that statins appear to be associated with a very low risk of serious liver injury and that routine periodic monitoring of transaminases does not appear to detect or prevent serious liver injury in association with statins.
本研究旨在评估阿曼苏丹国一家地区医院中他汀类药物所致肝脏不良反应的发生率、模式及诱发因素。
对2011年内科患者病历进行回顾性分析,以评估患者中可能与他汀类药物相关的任何肝功能障碍。对于每例疑似他汀类药物所致肝脏效应的病例,获取了关于时间关系、表现模式、管理、最终结局及任何促成因素的更多详细信息。此外,还评估了基于患者人口统计学和药物特征的肝脏效应发生差异。
共有927例符合纳入标准的患者纳入本研究。评估患者的平均年龄为63.1±11.37岁,他汀类药物使用的中位月数为22(四分位间距,43.25)。在927例患者中,有40例(4%)出现了被认为与他汀类药物相关的肝脏效应,仅12例(1%)患者观察到显著的转氨酶升高(>3倍)。发生疑似他汀类药物所致肝脏效应的患者与未发生者中,他汀类药物使用的中位月数分别为45(四分位间距,52)和21(四分位间距,43)个月,观察到的差异具有统计学意义。仅基于他汀类药物使用时间,观察到肝脏效应发生率存在显著差异。
在研究人群中,与他汀类药物相关的显著肝脏效应发生率较低。我们的结果支持包括美国食品药品监督管理局(US FDA)在内的最新建议,即他汀类药物似乎与严重肝损伤的风险极低相关,并且定期常规监测转氨酶似乎无法检测或预防与他汀类药物相关的严重肝损伤。