Lipidstoffwechsel aktuell: statininduzierte Myopathien

详细信息    查看全文

• 作者：L.L. Teichmann (1)
  Prof. Dr. M. Fleck (2) (3)
  
• 关键词：Lipidstoffwechsel ; Muskelerkrankungen ; Myopathie ; Statine ; Kreatinkinase ; Lipid metabolism ; Muscular diseases ; Myopathy ; Statins ; Creatine kinase
• 刊名：Zeitschrift f篓鹿r Rheumatologie
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：69
• 期：8
• 页码：696-701
• 全文大小：264KB
• 参考文献：1. Baer AN, Wortmann RL (2007) Myotoxicity associated with lipid-lowering drugs. Curr Opin Rheumatol 19:67鈥?3
  2. Bellosta S, Paoletti R, Corsini A (2004) Safety of statins: focus on clinical pharmacokinetics and drug interactions. Circulation 109:III50鈥揑II57 CrossRef
  3. Corsini A, Bellosta S, Baetta R et al (1999) New insights into the pharmacodynamic and pharmacokinetic properties of statins. Pharmacol Ther 84:413鈥?28 CrossRef
  4. Davidson MH (2004) Rosuvastatin safety: lessons from the FDA review and post-approval surveillance. Expert Opin Drug Saf 3:547鈥?57 CrossRef
  5. Gaist D, Rodr铆guez LA, Huerta C et al (2001) Lipid-lowering drugs and risk of myopathy: a population-based follow-up study. Epidemiology 12:565鈥?69 CrossRef
  6. Graham DJ, Staffa JA, Shatin D et al (2004) Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs. JAMA 292:2585鈥?590 CrossRef
  7. Hansen KE, Hildebrand JP, Ferguson EE, Stein JH (2005) Outcomes in 45 patients with statin-associated myopathy. Arch Intern Med 165:2671鈥?676 CrossRef
  8. Jones PH, Davidson MH (2005) Reporting rate of rhabdomyolysis with fenofibrate + statin versus gemfibrozil + any statin. Am J Cardiol 95:120鈥?22 CrossRef
  9. Kashani A, Phillips CO, Foody JM et al (2006) Risks associated with statin therapy: a systematic overview of randomized clinical trials. Circulation 114:2788鈥?797 CrossRef
  10. Keogh A, Macdonald P, Kaan A et al (2000) Efficacy and safety of pravastatin vs simvastatin after cardiac transplantation. J Heart Lung Transplant 19:529鈥?37 CrossRef
  11. Marie I, Delafen锚tre H, Massy N et al (2008) Tendinous disorders attributed to statins: a study on ninety-six spontaneous reports in the period 1990鈥?005 and review of the literature. Arthritis Rheum 59:367鈥?72 CrossRef
  12. Sathasivam S, Lecky B (2008) Statin induced myopathy. BMJ 337:a2286 CrossRef
  13. Sinzinger H, Wolfram R, Peskar BA (2002) Muscular side effects of statins. J Cardiovasc Pharmacol 40:163 CrossRef
  14. Smith CC, Bernstein LI, Davis RB et al (2003) Screening for statin-related toxicity: the yield of transaminase and creatine kinase measurements in a primary care setting. Arch Intern Med 163:688鈥?92 CrossRef
  15. Thompson PD, Clarkson PM, Rosenson RS, National Lipid Association Statin Safety Task Force Muscle Safety Expert Panel (2006) An assessment of statin safety by muscle experts. Am J Cardiol 97:69C鈥?6C CrossRef
  
• 作者单位：L.L. Teichmann (1)
  Prof. Dr. M. Fleck (2) (3)
  
  1. Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
  2. Klinik und Poliklinik f眉r Innere Medizin I, Universit盲tsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland
  3. Klinik f眉r Rheumatologie/Klinische Immunologie, Asklepios-Klinikum, Bad Abbach, Deutschland
  

文摘

Cardiovascular diseases are the most common causes of death in Germany and the prevalence is increased in patients with inflammatory rheumatic diseases. Statins are often employed for primary and secondary prophylaxis of cardiovascular events but can potentially induce myopathy as a side-effect. In addition to an asymptomatic elevation of muscle enzymes, myalgia and myositis as well as rhabdomyolysis, the most severe side-effect, have been observed, which are mostly manifested within 6 months after initiation of therapy. Statin-induced myopathy is rare but if risk factors are present, the individual risk can be much higher. Such factors are in particular interaction with other medications, statin dosage, the characteristics of the statin preparation used, comorbidities, age and sex of the patient. Regular testing of muscle enzymes after induction of statin therapy is not generally recommended for asymptomatic patients, but is indispensable when muscle symptoms appear. Statin therapy must be immediately terminated and a diagnostic evaluation must be carried out at the latest when creatine kinase values show a more than 10-fold increase.