Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update

被引:141
作者
Mancini, G. B. John [1 ]
Tashakkor, A. Yashar [1 ]
Baker, Steven [2 ]
Bergeron, Jean [3 ]
Fitchett, David [4 ]
Frohlich, Jiri [5 ]
Genest, Jacques [6 ]
Gupta, Milan [7 ]
Hegele, Robert A. [8 ,9 ]
Ng, Dominic S. [10 ]
Pearson, Glen J. [11 ]
Pope, Janet [12 ]
机构
[1] Univ British Columbia, Div Cardiol, Dept Med, Vancouver, BC V5Z 1M9, Canada
[2] McMaster Univ, Dept Med, Div Neurol & Rehabil, Hamilton, ON, Canada
[3] Univ Laval, Dept Med, Div Lipidol, Quebec City, PQ G1K 7P4, Canada
[4] Univ Toronto, Dept Med, Div Cardiol, Toronto, ON, Canada
[5] Univ British Columbia, Dept Pathol, Div Lab Med, Vancouver, BC, Canada
[6] McGill Univ, Dept Med, Div Cardiol, Montreal, PQ, Canada
[7] McMaster Univ, Dept Med, Div Cardiol, Hamilton, ON, Canada
[8] Schulich Sch Med, Dept Med, London, ON, Canada
[9] Schulich Sch Med, Robarts Res Inst, London, ON, Canada
[10] Univ Toronto, Dept Med, Div Endocrinol, Toronto, ON, Canada
[11] Univ Alberta, Dept Med, Div Cardiol, Edmonton, AB, Canada
[12] Schulich Sch Med, Dept Med, Div Rheumatol, London, ON, Canada
关键词
DENSITY-LIPOPROTEIN CHOLESTEROL; MUSCLE MITOCHONDRIAL METABOLISM; COA REDUCTASE INHIBITORS; CREATINE-KINASE LEVELS; CHRONIC KIDNEY-DISEASE; INDUCED MYOPATHY; DIABETES-MELLITUS; SKELETAL-MUSCLE; CARDIOVASCULAR-DISEASE; RHEUMATOID-ARTHRITIS;
D O I
10.1016/j.cjca.2013.09.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time.
引用
收藏
页码:1553 / 1568
页数:16
相关论文
共 155 条
[1]  
Abdulrazzaq HA, 2012, INT J PHARM PHARM S1, V4, P374
[2]  
Abdulrazzaq HA, 2012, INT J PHARM PHARM SC, V4, P446
[3]  
Alreja Gaurav, 2012, J Cardiovasc Dis Res, V3, P319, DOI 10.4103/0975-3583.102720
[4]  
Amarenco P, 2006, NEW ENGL J MED, V355, P549
[5]   2012 Update of the Canadian Cardiovascular Society Guidelines for the Diagnosis and Treatment of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult [J].
Anderson, Todd J. ;
Gregoire, Jean ;
Hegele, Robert A. ;
Couture, Patrick ;
Mancini, G. B. John ;
McPherson, Ruth ;
Francis, Gordon A. ;
Poirier, Paul ;
Lau, David C. ;
Grover, Steven ;
Genest, Jacques, Jr. ;
Carpentier, Andre C. ;
Dufour, Robert ;
Gupta, Milan ;
Ward, Richard ;
Leiter, Lawrence A. ;
Lonn, Eva ;
Ng, Dominic S. ;
Pearson, Glen J. ;
Yates, Gillian M. ;
Stone, James A. ;
Ur, Ehud .
CANADIAN JOURNAL OF CARDIOLOGY, 2013, 29 (02) :151-167
[6]  
Armour Ryan, 2013, J Clin Neuromuscul Dis, V14, P103, DOI 10.1097/CND.0b013e3182852558
[7]   Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials [J].
Baigent, C. ;
Blackwell, L. ;
Emberson, J. ;
Holland, L. E. ;
Reith, C. ;
Bhala, N. ;
Peto, R. ;
Barnes, E. H. ;
Keech, A. ;
Simes, J. ;
Collins, R. .
LANCET, 2010, 376 (9753) :1670-1681
[8]   Jaundice Due to Suspected Statin Hepatotoxicity: A Case Series [J].
Bergmann, Ottar M. ;
Kristjansson, Gudjon ;
Jonasson, Jon G. ;
Bjornsson, Einar S. .
DIGESTIVE DISEASES AND SCIENCES, 2012, 57 (07) :1959-1964
[9]   Rhabdomyolysis precipitated by a sitagliptin-atorvastatin drug interaction [J].
Bhome, R. ;
Penn, H. .
DIABETIC MEDICINE, 2012, 29 (05) :693-694
[10]  
Björnsson E, 2012, J HEPATOL, V56, P374, DOI [10.1016/j.jhep.2011.08.016, 10.1016/j.jhep.2011.07.023]