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他汀类药物的使用和安全性问题:过去、现在和未来的概述。

Statin use and safety concerns: an overview of the past, present, and the future.

机构信息

Indian Institute of Public Health-Delhi, Public Health Foundation of India , Gurgaon, India.

Academy of Scientific and Innovative Research (AcSIR), Ghaziabad - 201002, India

出版信息

Expert Opin Drug Saf. 2020 Aug;19(8):1011-1024. doi: 10.1080/14740338.2020.1796966. Epub 2020 Jul 31.

Abstract

INTRODUCTION

Dyslipidemia is a significant risk factor for cardiovascular disorders and contributes to significant morbidity and mortality associated with CAD and stroke worldwide. Statins are the most commonly prescribed drugs for the prevention and management of dyslipidemia globally. Although they provide immense therapeutic benefit, they are associated with clinically significant adverse effects, predominantly muscle, nerve, liver, and cognition-related besides new-onset diabetes. This has sparked various controversies, bringing to the fore, ambiguities that continue to exist in the scientific evidence, in relation to statin-associated harms. Therefore, it becomes essential to have a better understanding of safety issues related to statin use in various populations.

AREAS COVERED

This review describes the most common adverse effects of statins, examines available evidence and highlights the role of ethnicity, lipophilicity and other biological factors that could mediate and/or influence the relationship. MEDLINE was searched via PubMed to obtain relevant articles on dyslipidemia and statin safety.

EXPERT OPINION

The effectiveness of statins is presently unmatched. Further research is warranted to gain insights into the diverse pharmacological effects of statins in various population subgroups. This would assist prescribers in making better informed decisions. Specific treatment strategies for vulnerable groups can significantly attenuate harms, improve risk-benefit ratios, and ultimately enhance patient experience.

摘要

简介

血脂异常是心血管疾病的重要危险因素,也是全球范围内与 CAD 和中风相关的高发病率和高死亡率的主要原因。他汀类药物是全球预防和治疗血脂异常最常用的药物。尽管它们提供了巨大的治疗益处,但它们与临床上显著的不良反应相关,主要是肌肉、神经、肝脏和认知相关,此外还有新发糖尿病。这引发了各种争议,凸显了与他汀类药物相关危害相关的科学证据中仍然存在的模糊性。因此,更好地了解他汀类药物在不同人群中的安全性问题变得至关重要。

涵盖领域

本文描述了他汀类药物最常见的不良反应,检查了现有证据,并强调了种族、亲脂性和其他生物学因素的作用,这些因素可以调节和/或影响这种关系。通过 PubMed 在 MEDLINE 上搜索了有关血脂异常和他汀类药物安全性的相关文章。

专家意见

目前,他汀类药物的疗效是无与伦比的。需要进一步的研究来深入了解他汀类药物在不同人群亚组中的多种药理学作用。这将有助于医生做出更明智的决策。针对脆弱群体的特定治疗策略可以显著减轻危害,改善风险效益比,最终改善患者体验。

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