Section of Pharmacology, Department of Pharmacy and Drug Sciences, University of Bari "Aldo Moro", 70125 Bari, Italy.
Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy.
Int J Mol Sci. 2021 Feb 19;22(4):2070. doi: 10.3390/ijms22042070.
Statins are the most prescribed and effective drugs to treat cardiovascular diseases (CVD). Nevertheless, these drugs can be responsible for skeletal muscle toxicity which leads to reduced compliance. The discontinuation of therapy increases the incidence of CVD. Thus, it is essential to assess the risk. In fact, many studies have been performed at preclinical and clinical level to investigate pathophysiological mechanisms and clinical implications of statin myotoxicity. Consequently, new toxicological aspects and new biomarkers have arisen. Indeed, these drugs may affect gene transcription and ion transport and contribute to muscle function impairment. Identifying a marker of toxicity is important to prevent or to cure statin induced myopathy while assuring the right therapy for hypercholesterolemia and counteracting CVD. In this review we focused on the mechanisms of muscle damage discovered in preclinical and clinical studies and highlighted the pathological situations in which statin therapy should be avoided. In this context, preventive or substitutive therapies should also be evaluated.
他汀类药物是治疗心血管疾病 (CVD) 的最常用和最有效的药物。然而，这些药物可能会导致肌肉毒性，从而降低患者的顺应性。停止治疗会增加 CVD 的发病率。因此，评估风险至关重要。事实上，已经在临床前和临床水平进行了许多研究，以研究他汀类药物肌毒性的病理生理机制和临床意义。因此，出现了新的毒理学方面和新的生物标志物。事实上，这些药物可能会影响基因转录和离子转运，并导致肌肉功能障碍。确定毒性标志物对于预防或治疗他汀类药物引起的肌病、确保高胆固醇血症的正确治疗以及对抗 CVD 非常重要。在这篇综述中，我们重点介绍了在临床前和临床研究中发现的肌肉损伤机制，并强调了应避免他汀类药物治疗的病理情况。在这种情况下，还应评估预防性或替代性治疗。
