Evidence-Based Management of Statin Myopathy

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• 作者：Charles R. Harper (1)
  Terry A. Jacobson (2)
  
• 关键词：Myalgia ; Myopathy ; Muscle symptoms ; Statin ; Fibrates ; Drug safety ; Rhabdomyolysis ; Algorithm ; Drug interactions ; Myositis ; Coenzyme Q 10 ; Red yeast rice ; Creatine kinase ; Cholesterol ; Management ; Lipids ; Vitamin D ; Cytochrome metabolism ; Ezetimibe ; Colesevelam
• 刊名：Current Atherosclerosis Reports
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：12
• 期：5
• 页码：322-330
• 全文大小：401KB
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• 作者单位：Charles R. Harper (1)
  Terry A. Jacobson (2)
  
  1. Department of Medicine, Emory University, 49 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA
  2. Office of Health Promotion and Disease Prevention, Emory University, 49 Jesse Hill Jr Drive SE, Atlanta, GA, 30303, USA
  

文摘

Statin-associated muscle symptoms are a relatively common condition that may affect 10% to 15% of statin users. Statin myopathy includes a wide spectrum of clinical conditions, ranging from mild myalgia to rhabdomyolysis. The etiology of myopathy is multifactorial. Recent studies suggest that statins may cause myopathy by depleting isoprenoids and interfering with intracellular calcium signaling. Certain patient and drug characteristics increase risk for statin myopathy, including higher statin doses, statin cytochrome metabolism, and polypharmacy. Genetic risk factors have been identified, including a single nucleotide polymorphism of SLCO1B1. Coenzyme Q10 and vitamin D have been used to prevent and treat statin myopathy; however, clinical trial evidence demonstrating their efficacy is limited. Statin-intolerant patients may be successfully treated with either low-dose statins, alternate-day dosing, or using twice-weekly dosing with longer half-life statins. An algorithm is presented to assist the clinician in managing myopathy in patients with dyslipidemia.