Sezione di Gastroenterologia ed Epatologia, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Italy.
Sezione di Medicina Interna e Malattie Metaboliche, Dipartimento di Medicina Interna e Specialistica, DIBIMIS, Universita di Palermo, Palermo, Italy.
Curr Med Chem. 2018;25(42):5835-5846. doi: 10.2174/0929867325666180327095441.
Adverse drug reactions (ADRs) represent an important cause of morbidity and mortality worldwide. Statins are a class of drugs whose main adverse effects are drug-induced liver injury (DILI) and myopathy. Some of these may be predictable, due to their pharmacokinetic and pharmacodynamic properties, while others, unfortunately, are idiosyncratic. Genetic factors may also influence patient susceptibility to DILI and myopathy in the case of statins. This review will first discuss the role of statins in cardiovascular disease treatment and prevention and the underlying mechanisms of action. Furthermore, to explore the susceptibility of statin-induced adverse events such as myopathy and hepatotoxicity, it will then focus on the recent Genome-Wide Association Studies (GWAS) concerning the transporter genes, Cytochrome P450 (CYP), organic anion-transporting polypeptide (OATP) and ABCB1 and ABCC1, which seem to play a role in the development of clinically relevant adverse events. Finally, we appraise the evidence for and against the use of statins in metabolic syndrome and in HCV-infected patients, in terms of their safety and efficacy in cardiovascular events.
药物不良反应（ADRs）是全球范围内发病率和死亡率的重要原因。他汀类药物是一类药物，其主要的不良反应是药物性肝损伤（DILI）和肌病。其中一些可能是可预测的，这是由于它们的药代动力学和药效学特性，而另一些则是特发性的。遗传因素也可能影响他汀类药物引起的 DILI 和肌病患者的易感性。这篇综述将首先讨论他汀类药物在心血管疾病治疗和预防中的作用以及其作用机制。此外，为了探讨他汀类药物引起的不良反应（如肌病和肝毒性）的易感性，然后将重点关注最近与转运蛋白基因、细胞色素 P450（CYP）、有机阴离子转运多肽（OATP）和 ABCB1 和 ABCC1 有关的全基因组关联研究（GWAS），这些基因似乎在临床上相关的不良反应的发展中发挥作用。最后，我们将根据他汀类药物在心血管事件中的安全性和疗效，评估其在代谢综合征和 HCV 感染患者中的应用的证据。
