School of Medicine, University of Western Australia, Perth, WA, 6001, Australia.
Cardiometabolic Service, Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Australia.
Curr Atheroscler Rep. 2023 Feb;25(2):43-53. doi: 10.1007/s11883-022-01077-9. Epub 2023 Jan 7.
We describe and discuss the safety of statins and non-statin drugs in neuromuscular disorders (NMDs). We also propose a pragmatic model of care for the management of such cases.
Patients with both NMD and hypercholesterolemia may be particularly disadvantaged owing to the toxic effects of cholesterol-lowering therapy and the inability to take medication. Specifically, the management of hypercholesterolemia in patients with NMD is complicated by the increased risk of statin-related myotoxicity and concerns that statins may aggravate or possibly induce the onset of a specific NMD. The most severe form of statin-related myotoxicity is immune-mediated necrotizing myopathy. Management of hypercholesterolemia in patients with NMDs include treating modifiable factors, consideration of toxicity risk of statin, use of non-statin lipid lowering agents, noting possible drug interactions, and careful monitoring.
我们描述并讨论了他汀类药物和非他汀类药物在神经肌肉疾病（NMDs）中的安全性。我们还提出了一种实用的护理模式来管理此类病例。
患有 NMD 和高胆固醇血症的患者可能会特别处于不利地位，这是由于降脂治疗的毒性作用以及无法服用药物。具体来说，NMD 患者的高胆固醇血症的管理变得复杂，因为他汀类药物相关肌毒性的风险增加，以及他汀类药物可能加重或可能引发特定 NMD 的发病的担忧。最严重的他汀类药物相关肌毒性形式是免疫介导的坏死性肌病。NMD 患者的高胆固醇血症的管理包括治疗可改变的因素、考虑他汀类药物的毒性风险、使用非他汀类降脂药物、注意可能的药物相互作用以及仔细监测。
