Bezin Julien, Moore Nicholas
Inserm, UMR 1219, Bordeaux population health research center, team pharmacoepidemiology, université Bordeaux, 33076 Bordeaux, France.
Inserm CIC1401, Inserm CR1219, Bordeaux PharmacoEpi, université et CHU de Bordeaux, 33076 Bordeaux, France.
Therapie. 2019 Apr;74(2):261-269. doi: 10.1016/j.therap.2019.01.004. Epub 2019 Jan 18.
The evaluation of the real-life benefits and risks of statins in population is a major pharmacoepidemiological issue, given their widespread use for cardiovascular prevention. The purpose of this review was not to be exhaustive but to show the contributions of pharmacoepidemiology for various aspects of the evaluation of statins such as real-life drug use, effectiveness and risk. Statins are among the most used drugs in the world, but recent data show a slight decrease in use. Actual statin users are older, and have more comorbidities than those studied in clinical trials, but this does not seem to compromise their effectiveness, unlike the compliance issues that are common with these drugs. Beyond the known adverse reactions of statins from the clinical trials, risks of statins can be varied and sometimes difficult to evaluate, considering the ubiquity of cholesterol throughout the body, from drug or endogenous molecule metabolism to the construction of cell membranes or cell activities.
鉴于他汀类药物在心血管疾病预防方面的广泛应用，评估其在人群中的实际益处和风险是一个重大的药物流行病学问题。本综述的目的并非详尽无遗，而是展示药物流行病学在他汀类药物评估的各个方面所做的贡献，如实际用药情况、有效性和风险。他汀类药物是世界上使用最广泛的药物之一，但最近的数据显示其使用量略有下降。实际使用他汀类药物的患者年龄较大，合并症比临床试验中的患者更多，但这似乎并未影响其有效性，不过这些药物常见的依从性问题除外。除了临床试验中已知的他汀类药物不良反应外，考虑到胆固醇在全身无处不在，从药物或内源性分子代谢到细胞膜构建或细胞活动，他汀类药物的风险可能多种多样，有时难以评估。
