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他汀类药物所致肌病概述及未来展望

An overview of statin-induced myopathy and perspectives for the future.

作者信息

Nikolic Dragana, Banach Maciej, Chianetta Roberta, Luzzu Luca Marco, Pantea Stoian Anca, Diaconu Camelia Cristina, Citarrella Roberto, Montalto Giuseppe, Rizzo Manfredi

机构信息

Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy.

BELSS, Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy.

出版信息

Expert Opin Drug Saf. 2020 May;19(5):601-615. doi: 10.1080/14740338.2020.1747431. Epub 2020 Apr 13.

Abstract

: Statins remain the most commonly prescribed lipid-lowering drug class for the treatment of atherosclerotic cardiovascular disease. Their well-recognized side effects are known as statin-associated muscle symptom (SAMS). Some advances in this field have been made in recent years, but the understanding of the mechanisms has lagged. Investigating the specific role of the anti-HMGCR autoantibody, pharmacokinetic genetic variants, characterization of the known phenotypes of statin toxicity, in relation to clinical markers of disease, is of high importance.: We summarized currently available findings (on PubMed) related to SAMS and discussed the therapeutic approaches, risk factors, drug interactions, potential novel systems, algorithms and biomarkers for SAMS detection. CoQ10 supplementation has been suggested as a complementary approach to manage SAMS, while vitamin D levels may be useful for both the diagnosis and management.: Further studies might help to understand the easiest way to diagnose SAMS, suitable prevention and an effective non-statin therapy. This review sheds new light on the future directions in both research and clinical practice, which will help with rapid risk assessment, identification of the SAMS risk factors in order to decrease the incidence of statins' adverse effects, and the most effective therapy.

摘要

他汀类药物仍然是治疗动脉粥样硬化性心血管疾病最常用的降脂药物类别。它们广为人知的副作用被称为他汀类药物相关肌肉症状(SAMS)。近年来该领域取得了一些进展,但对其机制的理解仍滞后。研究抗HMGCR自身抗体的具体作用、药代动力学基因变异、他汀类药物毒性已知表型与疾病临床标志物的关系至关重要。我们总结了目前(在PubMed上)与SAMS相关的现有研究结果,并讨论了SAMS的治疗方法、危险因素、药物相互作用、潜在的新系统、算法以及检测生物标志物。已建议补充辅酶Q10作为管理SAMS的辅助方法,而维生素D水平可能对诊断和管理都有用。进一步的研究可能有助于了解诊断SAMS的最简单方法、合适的预防措施以及有效的非他汀类治疗方法。这篇综述为研究和临床实践的未来方向提供了新的思路,这将有助于快速进行风险评估、识别SAMS危险因素以降低他汀类药物不良反应的发生率,以及采用最有效的治疗方法。

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