Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy.
Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Int J Mol Sci. 2022 Jul 28;23(15):8364. doi: 10.3390/ijms23158364.
Statins are drugs widely prescribed in high-risk patients for cerebrovascular or cardiovascular diseases and are, usually, safe and well tolerated. However, these drugs sometimes may cause neuromuscular side effects that represent about two-third of all adverse events. Muscle-related adverse events include cramps, myalgia, weakness, immune-mediated necrotizing myopathy and, more rarely, rhabdomyolysis. Moreover, they may lead to peripheral neuropathy and induce or unmask a preexisting neuromuscular junction dysfunction. A clinical follow up of patients assuming statins could reveal early side effects that may cause neuromuscular damage and suggest how to better modulate their use. In fact, statin dechallenge or cessation, or the alternative use of other lipid-lowering agents, can avoid adverse events. This review summarizes the current knowledge on statin-associated neuromuscular adverse effects, diagnosis, and management. It is conceivable that the incidence of neuromuscular complications will increase because, nowadays, use of statins is even more diffused than in the past. On this purpose, it is expected that pharmacogenomic and environmental studies will help to timely predict neuromuscular complications due to statin exposure, leading to a more personalized therapeutic approach.
他汀类药物广泛用于脑血管或心血管疾病高危患者，通常安全且耐受良好。然而，这些药物有时可能会引起神经肌肉副作用，占所有不良事件的约三分之二。与肌肉相关的不良事件包括肌肉痉挛、肌痛、无力、免疫介导的坏死性肌病，更罕见的是横纹肌溶解症。此外，它们可能导致周围神经病，并诱发或揭示先前存在的神经肌肉接头功能障碍。对服用他汀类药物的患者进行临床随访，可以发现早期可能导致神经肌肉损伤的副作用，并提示如何更好地调整其使用。事实上，停用他汀类药物或改用其他降脂药物可以避免不良事件。这篇综述总结了他汀类药物相关的神经肌肉不良事件、诊断和管理的最新知识。可以想象，由于现在他汀类药物的使用比过去更加广泛，神经肌肉并发症的发生率将会增加。为此，预计药物基因组学和环境研究将有助于及时预测他汀类药物暴露引起的神经肌肉并发症，从而实现更个性化的治疗方法。
