کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
3000264 | 1180324 | 2008 | 14 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Toward “Pain-Free” Statin Prescribing: Clinical Algorithm for Diagnosis and Management of Myalgia
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کلمات کلیدی
AERSFDACyPULNCoQ10LDL-CHDL-CHMG-CoARCT3-hydroxy-3-methylglutaryl coenzyme A - 3 هیدروکسی 3-متیل گلوتاریل کوآنزیم ANCEP ATP III - NCEP ATP 3Randomized controlled trial - آزمایش تصادفی کنترل شدهExtended release - انتشار گستردهNational Cholesterol Education Program Adult Treatment Panel III - برنامه آموزش کلسترول ملی بالغ درمان بزرگسالانRisk difference - تفاوت خطرFood and Drug Administration - سازمان غذا و داروcytochrome P - سیتوکروم پAdverse Event Reporting System - سیستم گزارش رویداد نادرستadverse event - عارضه جانبی یا عوارض جانبیconfidence interval - فاصله اطمینانhigh-density lipoprotein cholesterol - لیپوپروتئین پرچگالی یا اچدیالodds ratio - نسبت شانس هاCreatine kinase - کراتین کینازtotal cholesterol - کلسترول تامLow-density lipoprotein cholesterol - کلسترول لیپوپروتئین با چگالی کمCoenzyme Q10 - کوآنزیم Q10
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
کاردیولوژی و پزشکی قلب و عروق
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چکیده انگلیسی
Myalgia, which often manifests as pain or soreness in skeletal muscles, is among the most salient adverse events associated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). Clinical issues related to statin-associated myotoxicity include (1) incidence in randomized controlled trials and occurrence in postmarketing surveillance databases; (2) potential differences between statins in their associations with such adverse events; and (3) diagnostic and treatment strategies to prevent, recognize, and manage these events. Data from systematic reviews, meta-analyses, clinical and observational trials, and postmarketing surveillance indicate that statin-associated myalgia typically affects approximately 5.0% of patients, as myopathy in 0.1% and as rhabdomyolysis in 0.01%. However, studies also suggest that myalgia is among the leading reasons patients discontinue statins (particularly high-dose statin monotherapy) and that treatment with certain statins (eg, fluvastatin) is unlikely to result in such adverse events. This review presents a clinical algorithm for monitoring and managing statin-associated myotoxicity. The algorithm highlights risk factors for muscle toxicity and provides recommendations for (1) creatine kinase measurements and monitoring; (2) statin dosage reduction, discontinuation, and rechallenge; and (3) treatment alternatives, such as extended-release fluvastatin with or without ezetimibe, low-dose or alternate-day rosuvastatin, or ezetimibe with or without colesevelam. The algorithm should help to inform and enhance patient care and reduce the risk of myalgia and other potentially treatment-limiting muscle effects that might undermine patient adherence and compromise the overall cardioprotective benefits of statins.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Mayo Clinic Proceedings - Volume 83, Issue 6, June 2008, Pages 687-700
Journal: Mayo Clinic Proceedings - Volume 83, Issue 6, June 2008, Pages 687-700
نویسندگان
Terry A. MD,