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国家糖尿病、内分泌与遗传学中心就诊患者中的他汀类药物所致肌病

Statin Induced Myopathy Among Patients Attending the National Center for Diabetes, endocrinology, & genetics.

作者信息

Abed Waddah, Abujbara Mousa, Batieha Anwar, Ajlouni Kamel

机构信息

Department of Endocrinology, The National Center (Institute) for Diabetes, Endocrinology, and Genetics, The University of Jordan, Amman, Jordan.

Department of Public Health, Jordan University of Science and Technology (JUST), Irbid, Jordan.

出版信息

Ann Med Surg (Lond). 2022 Jan 27;74:103304. doi: 10.1016/j.amsu.2022.103304. eCollection 2022 Feb.

Abstract

BACKGROUND AND OBJECTIVES

myopathy is a major side effect of statins that leads to statin intolerance and discontinuation. In this prospective cohort study, the main objective was to estimate the incidence of myopathy in patients receiving statins. In addition, we identified some risk factors associated with statin induced myopathy.

METHODS

A prospective cohort study was conducted at the National Center for Diabetes, Endocrinology and Genetics [NCDEG] in Jordan from October 1, 2018 to January 31, 2021. All subjects who initiated statin therapy followed up during that period. Data was collected at time 0 (baseline), 3, 6, 9, and 12 months after enrollment. Demographic and clinical data were collected from medical records. Muscular symptoms were collected by conducting face-to-face interviews to all patients using a pre-structured questionnaire.

RESULTS

The overall incidence of myopathy among patients taking statins was 27.8%, 31.4% in males and 22.6% in females, the incidence of myopathy was higher in older people, being highest in patients ≥60 years (34%). Bivariate analyses showed no significant association between myopathy and hypothyroidism, diabetes or medications that are known to interact with statins. The incidence of myopathy was highest with Simvastatin 40 mg (50%) and lowest with Fluvastatin XL 80 mg (8%) and Rosuvastatin 10 mg (10.8%).

CONCLUSIONS

The overall incidence of myopathy in patients taking statins was 27.8%. Myopathy was directly related to dose and type of statin used. The use of Fluvastatin XL 80 mg and Rosuvastatin 10 mg showed less incidence of myopathy compared with other statins.

摘要

背景与目的

肌病是他汀类药物的主要副作用,可导致他汀类药物不耐受和停药。在这项前瞻性队列研究中,主要目的是估计接受他汀类药物治疗的患者中肌病的发生率。此外,我们还确定了一些与他汀类药物引起的肌病相关的危险因素。

方法

2018年10月1日至2021年1月31日,在约旦国家糖尿病、内分泌与遗传学中心[NCDEG]进行了一项前瞻性队列研究。所有开始他汀类药物治疗的受试者在该期间接受随访。在入组后0(基线)、3、6、9和12个月收集数据。人口统计学和临床数据从病历中收集。通过使用预先构建的问卷对所有患者进行面对面访谈来收集肌肉症状。

结果

服用他汀类药物的患者中肌病的总体发生率为27.8%,男性为31.4%,女性为22.6%,老年人中肌病的发生率更高,≥60岁的患者中最高(34%)。双变量分析显示肌病与甲状腺功能减退、糖尿病或已知与他汀类药物相互作用的药物之间无显著关联。辛伐他汀40mg时肌病发生率最高(50%),氟伐他汀XL 80mg和瑞舒伐他汀10mg时最低(分别为8%和10.8%)。

结论

服用他汀类药物的患者中肌病的总体发生率为27.8%。肌病与所用他汀类药物的剂量和类型直接相关。与其他他汀类药物相比,使用氟伐他汀XL 80mg和瑞舒伐他汀10mg时肌病的发生率较低。

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