达丁类药物相关的肌肉病变
Paul D Thompson1, Priscilla Clarkson, Richard H Karas
1Preventive Cardiology and Cardiovascular Research, Division of Cardiology, Hartford Hospital, Hartford, Conn 06102, USA. pthomps@harthosp.org
JAMA
|April 4, 2003
概括
类药物可以引起肌肉问题,从轻微的疼痛到严重的狂肌痛. 风险因素和药物相互作用可能会增加这些不良影响,其机制仍在研究中.
科学领域:
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
- 临床医学 临床医学
背景情况:
- 类他类药物,HMG-CoA减少酶抑制剂,广泛用于胆固醇管理.
- 这些药物与一系列骨肌肉疾病有关,从肌痛到狂肌痛.
- 了解这些不良影响对于患者的安全和有效的降脂疗法至关重要.
研究的目的:
- 为提供关于他类药物相关肌肉病的临床总结.
- 讨论潜在的机制,基础的他类药物诱导的肌肉损伤.
- 更新使用FDA数据的关于他类药物相关性拉布地质溶解的报告.
主要方法:
- 通过PubMed (截至2002年11月) 对他类肌肉病学文章的文献评论.
- 关于他类药物的临床试验,病例系列和综述的综述 (PubMed至2003年1月).
- 分析FDA MEDWATCH关于他类药物相关性狂犬病的不良事件报告 (1990年1月 - 2002年3月).
主要成果:
- 在他类药物临床试验中,肌肉问题很少出现.
- 美国食品和药物管理局 (FDA) 的MEDWATCH系统记录了3339例与他类药物相关的狂肌溶解病例,其中黄是最受影响的.
- 关于较不严重的肌肉症状 (疼痛,软弱) 的数据表明患病率为1-5%;危险因素和药物相互作用 (例如,gemfibrozil) 可能会加剧不良反应.
结论:
- 类他类药物相关肌肉病包括一系列肌肉问题,包括罕见但严重的狂肌病.
- 器官功能障碍,并发症和药物相互作用等因素显著影响肌肉病的风险.
- 虽然机制尚未完全阐明,但他类药物可能会通过减少调节性蛋白质生产来损害肌细胞维护.
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