治疗高胆固醇血症的他汀类药物替代品--安全性评估。

IF 3 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Weiwei Zeng, Brian Tomlinson
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引用次数: 0

摘要

导言:他汀类药物是降低低密度脂蛋白胆固醇(LDL-C)和心血管(CV)事件的一线治疗药物,但有些患者无法耐受有效剂量的他汀类药物,有时甚至无法耐受任何剂量的他汀类药物,因此可能需要使用替代疗法。专家观点:在本综述中,我们总结了通过PubMed搜索获得的相关已发表文献,这些文献涉及他汀类药物替代品治疗高胆固醇血症的安全性:专家观点:他汀类药物的主要替代药物有依折麦布、蛋白转换酶亚基酶/kexin 9型(PCSK9)抑制剂、evolocumab、alirocumab和inclisiran,以及最近获批的贝美多克酸。这些药物都显示出极佳的安全性,与骨骼肌症状或新发糖尿病风险增加无关,也没有重大的药物相互作用。注射用 PCSK9 抑制剂与注射部位反应的小幅增加有关,这些反应通常为轻度或中度。本贝多酸与易感人群血浆尿酸的小幅升高和痛风发作频率的轻微增加有关。与安全性问题相比,他汀类药物替代品的成本、可获得性和所需的低密度脂蛋白胆固醇降低程度更有可能决定患者的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Statin alternatives for the treatment of hypercholesterolemia - a safety evaluation.

Introduction: Statins are well established as the first-line treatment to reduce low-density-lipoprotein cholesterol (LDL-C) and cardiovascular (CV) events, but some patients are unable to tolerate effective doses or sometimes any dose of statins and alternative treatments may be required.

Areas covered: In this review we summarize the relevant published literature obtained from a PubMed search on the safety of statin alternatives for the treatment of hypercholesterolemia.

Expert opinion: The main alternatives to statins are ezetimibe, the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, evolocumab, alirocumab, and inclisiran, and the recently approved bempedoic acid. These have all shown an excellent safety profile and have not been associated with skeletal muscle symptoms or with increased risk of new onset diabetes and they have no major drug interactions. The injectable PCSK9 inhibitors are associated with a small increase in injection site reactions which are usually of mild or moderate intensity. Bempedoic acid is associated with a small increase in plasma uric acid and slightly increased frequency of episodes of gout in susceptible subjects. The cost and availability and the degree of lowering of LDL-C required are more likely to determine the choice of statin alternatives than the safety issues.

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来源期刊
CiteScore
5.90
自引率
3.20%
发文量
97
审稿时长
6-12 weeks
期刊介绍: Expert Opinion on Drug Safety ranks #62 of 216 in the Pharmacology & Pharmacy category in the 2008 ISI Journal Citation Reports. Expert Opinion on Drug Safety (ISSN 1474-0338 [print], 1744-764X [electronic]) is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles on all aspects of drug safety and original papers on the clinical implications of drug treatment safety issues, providing expert opinion on the scope for future development.
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