Johns Hopkins Myositis Center, Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Internal Medicine, Texas Tech University Health Science Center, Amarillo, TX, USA.
Curr Rheumatol Rep. 2024 Jul;26(7):260-268. doi: 10.1007/s11926-024-01143-y. Epub 2024 Apr 5.
Hyperlipidemia is the major cardiovascular morbidity and mortality risk factor. Statins are the first-line treatment for hyperlipidemia. Statin-associated muscle symptoms (SAMS) are the main reason for the discontinuation of statins among patients. The purpose of this review is to guide clinicians to recognize the difference between self-limited and autoimmune statin myopathy in addition to the factors that potentiate them. Finally, treatment strategies will be discussed. This review mostly focuses on new data in the past 3 years.
Recent findings suggest that SAMS is a complex and multifactorial condition that involves mitochondrial dysfunction, oxidative stress, and immune-mediated mechanisms. Effective management of SAMS requires a thorough evaluation of the patient's symptoms, risk factors, and medication history, as well as consideration of alternative treatment options. While statins are effective in reducing the risk of cardiovascular events, their use is associated with a range of adverse effects, including SAMS.
高脂血症是主要的心血管发病率和死亡率的危险因素。他汀类药物是治疗高脂血症的一线药物。他汀类药物相关肌肉症状（SAMS）是导致患者停止使用他汀类药物的主要原因。本综述的目的是指导临床医生除了增强因素外，还能识别自限性和自身免疫性他汀类药物肌病之间的差异。最后，将讨论治疗策略。本综述主要关注过去 3 年中的新数据。
最近的研究结果表明，SAMS 是一种复杂的多因素疾病，涉及线粒体功能障碍、氧化应激和免疫介导的机制。SAMS 的有效管理需要对患者的症状、风险因素和药物治疗史进行全面评估，并考虑替代治疗方案。虽然他汀类药物在降低心血管事件风险方面非常有效，但它们的使用与一系列不良反应有关，包括 SAMS。
