Statin-Associated Myopathy

摘要: Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are associated with skeletal muscle complaints, including clinically important myositis and rhabdomyolysis, mild serum creatine kinase (CK) elevations, myalgia with without elevated CK levels, weakness, cramps, persistent myalgia elevations after statin withdrawal. We performed a literature review to provide clinical summary of statin-associated myopathy discuss possible mediating mechanisms. also update the US Food Drug Administration (FDA) reports on rhabdomyolysis. Articles myopathy were identified via PubMed search through November 2002 articles on statin trials, case series, review were via a January 2003. Adverse event statin-associated rhabdomyolysis collected from FDA MEDWATCH database. The found that problems during trials are extremely rare. Reporting System lists 3339 cases of statin-associated rhabdomyolysis reported between 1, 1990, March 31, 2002. Cerivastatin was most commonly implicated statin. Few data are available regarding frequency less-serious events such as pain and which may affect 1% 5% patients. risk rhabdomyolysis and other adverse effects use can be exacerbated by several factors, including compromised hepatic renal function, hypothyroidism, diabetes, and concomitant medications. Medications fibrate gemfibrozil alter statin metabolism increase plasma concentration. How statins injure skeletal is not clear, although recent evidence suggests statins reduce production small regulatory proteins are important for myocyte maintenance.