Do you have to stop the medicine after a adverse reaction of his muscle muscle?When to use it again?
In 1976, Japanese -based chemist AKIRA ENDO first obtained the Schastatin when studying fungal metabolism and cholesterol synthesis. The test in the 1980s confirmed the lipid reduction effect of his drug. After Luozatin was approved by the US Food and Drug Administration (FDA) as the first Jetine -class drug in 1987, the Bettin, Putacin, Flosvas, Ru Shuzanda, Avastein, and Westerniaza Bentein were approved. Waiting for a series of Jetine drugs are continuously launched.
Due to the good lipid -lowering effects of his drugs, it has widely used the application of fat reduction and coronary heart disease prevention. While obtaining better fat regulation, the drug adverse reactions cannot be ignored.
The adverse reactions of statin drugs include liver function abnormalities, myocardiasis, myolatal inflammation, transverse muscle solubility, induced diabetes, and causing cognitive dysfunction. In 2001, the “Bystant” incident in the United States caused the doctor and patient’s muscle -related symptoms to the disease -related symptoms.
What is his muscle -related muscle symptoms (SAMS)?
Stomp research proposes that SAMS refers to the new symptoms of the new occurrence of new symptoms and ≤ 12 weeks after the drug is enabled. It improves 2 days to 4 weeks after stopping the drug, and the symptoms of ≥2 days and ≤ 12 weeks appear. In 2016, the “muscle symptoms” of the Canadian Consensus Working Group included myocardiasis [osteubica/muscle weakness+serum omoscestranstease (CK) normal], myolatal inflammation [ominana/muscle weakness+CK increase> normal value upper limit (ULN) ], Muscle dissolving (CK> 40 × ULN may be caused by muscle red proteinuria).
Which patients are easy to occur in SAMS?
The prone factors of SAMS are mainly:
Patient factors: elderly, Asian, physical disability, low body weight index, unprepared thyroid dysfunction, liver and kidney dysfunction, infection, muscle disease, severe exercise, genetic, etc.;
Drug factors: The dosage of Jisin, combined with medication such as calcium antagonists, amine iodine, erythromycin, cratconzol, cypamolin, omepizole, fluoronazole, Jitirozi, etc. It
Others: grapefruit juice, alcohol, etc.
Another study has shown that his category drugs increase muscle damage caused by exercise. Research on genetic factors confirmed that SLCO1B1 gene polymorphism is also closely related to his muscle disease risk related to Hisine.
How to evaluate the possibility of SAMS?
If you suspect SAMS, the possibility of evaluation of SAMS is combined with clinical symptoms, symptoms distribution/frequency, symptoms time, symptoms time, and re -taking symptoms of drug symptoms. SAMS score ≥9 is very likely, 7-8 is possible, <7 is impossible.
In addition, the “SAMS-CI” (SAMS-CI) scoring evaluation of the American Last Last Society (NLA) can also be applied to the possibility of SAMS. (See Figure 1 in detail)
Can Jetine drugs be used safely?
Recently, the American Heart Association (AHA) has issued a scientific statement on the safety of Hisatin drugs. The analysis of random double -blind control research on the highest dose of Biting drugs currently applied by many applications shows that his category drugs and comfort are comfortable. The incidence of muscle symptoms of the agent is almost different (≤1%). Muscle disease caused by his category drugs, including transverse muscle dissolving, is less than 0.1%at the maximum recommended therapeutic dose. This science aims to show that the clinical application of commonly used Hisatin drugs is far greater than risks.
How to restart lipid -lowering treatment after SAMS?
For patients who have clearly occurred in SAMS, lipid -reducing treatment should be based on improving lifestyle. If drugs need to be used at the same time, you can try to use low -dose statins, use Herine, give medicine every other day, or choose non -Batin -like drugs.
Finally, I wish you all a smooth and good in 2019, good health ~
references:
[1] Liang Feng, Shen Zhujun, Fang Quan, ET al. The interpretation of the consensus of expert consensus on the consensus of the European atherosclerotic Society on the influence of Hisatin drugs related to his muscle symptoms [J]. 10): 1281-1285.
[2] Harsha V. GANGA, MD, Hanna B, Et Al. A Systematic Review of Statin-Inducedmuscle Privems in Clinical Trials [J]. American Heart Journal.2013.
[3] SLCO1B1 VariaTs and Statin-Induced Myopathy A Genomewide Study. N English, 2008.
[4] Parker Ba, Capizzi Ja, Grimaldi as, etal. Effect of Statins on Skeletal Muscle Function [J] .Circulation, 2013, 127.
