NEMA Research, Inc., Naples, FL, USA.
Department of Medical and Surgical Sciences and Biotechnologies, Unit of Anaesthesia, Intensive Care and Pain Medicine, Sapienza University of Rome, Rome, Italy.
Expert Rev Clin Pharmacol. 2020 Mar;13(3):299-310. doi: 10.1080/17512433.2020.1734451. Epub 2020 Feb 27.
: Statins remain among the most frequently prescribed drugs and constitute a cornerstone in the prevention of cardiovascular disease. However, muscle symptoms are often reported from patients on statins. Muscle symptoms are frequently reported as adverse events associated with statin therapy.: In the present narrative review, statin-associated muscle pain is discussed. It elucidates potential mechanisms and possible targets for management.: In general, the evidence in support of muscle pain caused by statins is in some cases equivocal and not particularly strong. Reported symptoms are difficult to quantify. Rarely is it possible to establish a causal link between statins and muscle pain. In randomized controlled trials, statins are well tolerated, and muscle-pain related side-effects is similar to placebo. There are also nocebo effects of statins. Exchange of statin may be beneficial although all statins have been associated with muscle pain. In some patients reduction of dose is worth trying, especially in primary prevention Although the benefits of statins outweigh potential risks in the vast majority of cases, careful clinical judgment may be necessary in certain cases to manage potential side effects on an individual basis.
他汀类药物仍然是最常开的药物之一，是预防心血管疾病的基石。然而，服用他汀类药物的患者常报告有肌肉症状。肌肉症状常被报告为与他汀类药物治疗相关的不良反应。在本叙述性综述中，讨论了与他汀类药物相关的肌肉疼痛。它阐明了潜在的机制和可能的管理目标。一般来说，他汀类药物引起肌肉疼痛的证据在某些情况下是模棱两可的，并不是特别强。报告的症状难以量化。很少有可能在他汀类药物和肌肉疼痛之间建立因果关系。在随机对照试验中，他汀类药物耐受性良好，与安慰剂相比，肌肉疼痛相关的副作用相似。他汀类药物也有反安慰剂效应。虽然所有的他汀类药物都与肌肉疼痛有关，但交换他汀类药物可能是有益的。在某些患者中，减少剂量是值得尝试的，尤其是在一级预防中。虽然在绝大多数情况下，他汀类药物的益处超过了潜在风险，但在某些情况下，可能需要根据个体情况进行谨慎的临床判断，以管理潜在的副作用。
