Statin Intolerance: Diagnosis and Remedies

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• 作者：Angela Pirillo ; Alberico Luigi Catapano
• 关键词：Statins ; Statin intolerance ; Myopathy ; Myalgia
• 刊名：Current Cardiology Reports
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：17
• 期：5
• 全文大小：241 KB
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• 作者单位：Angela Pirillo (1) (2)
  Alberico Luigi Catapano (2) (3)
  
  1. Center for the Study of Atherosclerosis, E. Bassini Hospital, Via M. Gorki 50, Cinisello Balsamo, Milan, Italy
  2. IRCCS Multimedica, Milan, Italy
  3. Department of Pharmacological and Biomolecular Sciences, Universit脿 degli Studi di Milano, via Balzaretti, 9, 20133, Milan, Italy
  
• 刊物主题：Cardiology;
• 出版者：Springer US
• ISSN：1534-3170

文摘

Despite the efficacy of statins in reducing cardiovascular events in both primary and secondary prevention, the adherence to statin therapy is not optimal, mainly due to the occurrence of muscular adverse effects. Several risk factors may concur to the development of statin-induced myotoxicity, including patient-related factors (age, sex, and race), statin properties (dose, lipophilicity, and type of metabolism), and the concomitant administration of other drugs. Thus, the management of patients intolerant to statins, particularly those at high or very high cardiovascular risk, involves alternative therapies, including the switch to another statin or the use of intermittent dosage statin regimens, as well as nonstatin lipid lowering drugs (ezetimibe and fibrates) or new hypolipidemic drugs such as PCSK9 monoclonal antibodies, the antisense oligonucleotide against the coding region of human apolipoprotein B mRNA (mipomersen), and microsomal triglyceride transfer protein inhibitor lomitapide. Ongoing clinical trials will reveal whether the lipid-lowering effects of alternative therapies to statins can also translate into a cardiovascular benefit.