Safitri Nisa, Alaina Maya Fadila, Pitaloka Dian Ayu Eka, Abdulah Rizky
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, 45363, Indonesia.
Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, 45363, Indonesia.
Drug Healthc Patient Saf. 2021 Nov 8;13:211-219. doi: 10.2147/DHPS.S333738. eCollection 2021.
Although statins are effective for treating hypercholesterolemia, they can have various side effects, including rhabdomyolysis, a potentially fatal condition. This review evaluated the incidence and underlying molecular mechanism of statin-induced rhabdomyolysis and analyzed its risk factors, prevention, and management. We focused on the clinical and randomized clinical trials of statin monotherapies and combinations with other drugs. The primary mechanism of statin therapy-induced rhabdomyolysis is believed to be a decrease in ubiquinone (coenzyme Q) produced by the HMG-CoA pathway. Additionally, different types of lipophilic and hydrophilic statins play a role in causing rhabdomyolysis. Although statin-induced rhabdomyolysis has a low incidence, there is no guarantee that patients will be free of this side effect. Rhabdomyolysis can be prevented by reducing the risk factors, such as using CYP3A4 inhibitors, using high-dose statins, and strenuous physical activities.
尽管他汀类药物对治疗高胆固醇血症有效，但它们可能有各种副作用，包括横纹肌溶解症，这是一种潜在的致命病症。本综述评估了他汀类药物诱导的横纹肌溶解症的发生率和潜在分子机制，并分析了其危险因素、预防措施和管理方法。我们重点关注了他汀类单药治疗以及与其他药物联合使用的临床和随机临床试验。他汀类药物治疗引起横纹肌溶解症的主要机制被认为是HMG-CoA途径产生的泛醌（辅酶Q）减少。此外，不同类型的亲脂性和亲水性他汀类药物在引起横纹肌溶解症方面也起作用。尽管他汀类药物诱导的横纹肌溶解症发生率较低，但不能保证患者不会出现这种副作用。可以通过降低危险因素来预防横纹肌溶解症，例如使用CYP3A4抑制剂、使用高剂量他汀类药物以及剧烈的体育活动。
