Jeeyavudeen Mohammad S, Pappachan Joseph M, Arunagirinathan Ganesan
Western General Hospital, Edinburgh Centre for Endocrinology Diabetes, Edinburgh, UK.
Lancashire Teaching Hospitals NHS Trust, Lancashire, UK.
touchREV Endocrinol. 2022 Nov;18(2):89-95. doi: 10.17925/EE.2022.18.2.89. Epub 2022 Nov 21.
The efficacy of statins in the primary and secondary prevention of cardiovascular disease has been proven beyond doubt. The number needed to treat to prevent one cardiovascular event is 1 in 30 over 10 years, and the number needed to treat for secondary prevention is much lower. However, a recent study demonstrated that only 68% of eligible patients are on statin therapy. Moreover, there seems to be a reluctance to escalate statin doses due to the fear of adverse effects. The adverse effects that worries patients and their physicians most frequently are those related to muscular symptoms. N-of-1 trial evidence suggests that muscular symptoms attributed to statins are often caused by the nocebo effect. This article aims to provide a structured, evidence-based approach to suspected statin-related muscle toxicity.
他汀类药物在心血管疾病一级和二级预防中的疗效已得到确凿证实。在10年时间里，预防一次心血管事件所需治疗的人数为30人中的1人，而二级预防所需治疗的人数则低得多。然而，最近一项研究表明，只有68%的符合条件的患者接受他汀类药物治疗。此外，由于担心不良反应，似乎存在不愿增加他汀类药物剂量的情况。患者及其医生最常担心的不良反应是与肌肉症状相关的不良反应。单病例试验证据表明，他汀类药物所致的肌肉症状通常是由反安慰剂效应引起的。本文旨在提供一种结构化的、基于证据的方法来处理疑似他汀类药物相关的肌肉毒性。
