Arnadottir M, Eriksson L O, Thysell H, Karkas J D
Department of Nephrology, University Hospital, Lund, Sweden.
Nephron. 1993;65(3):410-3. doi: 10.1159/000187521.
A few cases of severe rhabdomyolysis have been reported in heart transplant recipients treated simultaneously with ciclosporin (CS) and the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor lovastatin. When measured, plasma lovastatin HMG-CoA reductase inhibitor concentrations in these patients were higher than expected. This prompted us to study the plasma concentration profiles of simvastatin HMG-CoA reductase inhibitory activity after a single dose of simvastatin in kidney transplant recipients. Five patients treated with CS, azathioprine and prednisolone (CS patients) were compared to 5 patients treated with azathioprine and prednisolone (non-CS patients). The concentration curves had similar shapes but the mean area under the curve/24 h was almost 3 times higher (p = 0.047) and the mean peak concentration was twice as high in CS patients (p = 0.028). These results suggest a difference in the disposition of simvastatin in CS patients as compared to non-CS patients. Simvastatin should be administered in a reduced dosage to CS patients.
有报道称，一些同时接受环孢素（CS）和3-羟基-3-甲基戊二酰辅酶A（HMG-CoA）还原酶抑制剂洛伐他汀治疗的心脏移植受者出现了严重横纹肌溶解症。在对这些患者进行检测时，其血浆中洛伐他汀HMG-CoA还原酶抑制剂的浓度高于预期。这促使我们研究肾移植受者单次服用辛伐他汀后辛伐他汀HMG-CoA还原酶抑制活性的血浆浓度曲线。将5例接受CS、硫唑嘌呤和泼尼松龙治疗的患者（CS患者）与5例接受硫唑嘌呤和泼尼松龙治疗的患者（非CS患者）进行比较。浓度曲线形状相似，但CS患者曲线下面积/24小时的平均值几乎高出3倍（p = 0.047），平均峰值浓度高出1倍（p = 0.028）。这些结果表明，与非CS患者相比，CS患者体内辛伐他汀的处置存在差异。应减少CS患者辛伐他汀的给药剂量。
