Kelsey Klein, Maia Klimatcheva, Reed Hall, Rupal Patel, Kermit V Speeg, Juan Guerrero, Christina Long
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The primary outcome was a composite of statin-related myalgia, statin-related rhabdomyolysis, and creatine kinase above the upper limit of normal. Secondary outcomes included liver function tests above 3 times the upper limit of normal, statin discontinuation, and statin dose decrease and associated reason. <b>Results:</b> A total of 178 recipients were included, with 100 receiving low-to-moderate-intensity statins and 78 receiving high-intensity statins. There were no differences between groups for statin-related myalgia, and no reported cases of statin-related rhabdomyolysis in either group. Low to moderate intensity statin use was associated with an increased rate of liver function test elevation (26% vs 11.5%, <i>P</i> = .014) occurring a median of 306 days (interquartile range [IQR] 134-725) post-statin initiation. <b>Conclusion:</b> In liver and kidney transplant recipients receiving tacrolimus, the use of high-intensity statins was not associated with an increased risk of myalgia, rhabdomyolysis, or elevated creatinine kinase when compared with low-to-moderate-intensity statin use.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":" ","pages":"15269248251349768"},"PeriodicalIF":0.6000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Safety of Concomitant Use of Tacrolimus and High-Intensity Statins in Liver and Kidney Transplant Recipients.\",\"authors\":\"Kelsey Klein, Maia Klimatcheva, Reed Hall, Rupal Patel, Kermit V Speeg, Juan Guerrero, Christina Long\",\"doi\":\"10.1177/15269248251349768\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Due to increased risk of myalgia and rhabdomyolysis associated with the use of simvastatin with cyclosporine, use of high-intensity 3-hydroxy-3-methylglutaryl Coenzyme A reductase inhibitors (statins) is often avoided in transplant recipients. <b>Aim:</b> This program evaluation aimed to determine the safety of high-intensity statins in liver and kidney transplant recipients taking tacrolimus. <b>Design:</b> All liver and kidney transplant recipients who filled prescriptions for tacrolimus and any statin except for simvastatin between June 15, 2020 and July 22, 2022 were screened for inclusion. High-intensity was defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 or 40 mg. The primary outcome was a composite of statin-related myalgia, statin-related rhabdomyolysis, and creatine kinase above the upper limit of normal. Secondary outcomes included liver function tests above 3 times the upper limit of normal, statin discontinuation, and statin dose decrease and associated reason. <b>Results:</b> A total of 178 recipients were included, with 100 receiving low-to-moderate-intensity statins and 78 receiving high-intensity statins. There were no differences between groups for statin-related myalgia, and no reported cases of statin-related rhabdomyolysis in either group. 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引用次数: 0
摘要
由于辛伐他汀与环孢素联合使用会增加肌痛和横纹肌溶解的风险,移植受者通常避免使用高强度的3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂(他汀类药物)。目的:本项目评估旨在确定高强度他汀类药物在服用他克莫司的肝肾移植受者中的安全性。设计:所有在2020年6月15日至2022年7月22日期间服用他克莫司和辛伐他汀以外的任何他汀类药物的肝脏和肾脏移植受者都被筛选纳入研究。高剂量定义为阿托伐他汀40或80mg,瑞舒伐他汀20或40mg。主要结果是他汀类药物相关肌痛、他汀类药物相关横纹肌溶解和肌酸激酶高于正常上限的综合结果。次要结局包括肝功能检查高于正常上限3倍、他汀类药物停药、他汀类药物剂量减少及相关原因。结果:共纳入178例患者,其中100例接受低至中等强度他汀类药物治疗,78例接受高强度他汀类药物治疗。两组间他汀类药物相关肌痛无差异,两组均无他汀类药物相关横纹肌溶解的病例报道。低至中等强度他汀类药物的使用与他汀类药物开始使用后中位306天(四分位间距[IQR] 134-725)肝功能测试升高率升高相关(26% vs 11.5%, P = 0.014)。结论:在接受他克莫司的肝肾移植受者中,与使用低至中等强度他汀相比,使用高强度他汀与肌痛、横纹肌溶解或肌酐激酶升高的风险增加无关。
Safety of Concomitant Use of Tacrolimus and High-Intensity Statins in Liver and Kidney Transplant Recipients.
Due to increased risk of myalgia and rhabdomyolysis associated with the use of simvastatin with cyclosporine, use of high-intensity 3-hydroxy-3-methylglutaryl Coenzyme A reductase inhibitors (statins) is often avoided in transplant recipients. Aim: This program evaluation aimed to determine the safety of high-intensity statins in liver and kidney transplant recipients taking tacrolimus. Design: All liver and kidney transplant recipients who filled prescriptions for tacrolimus and any statin except for simvastatin between June 15, 2020 and July 22, 2022 were screened for inclusion. High-intensity was defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 or 40 mg. The primary outcome was a composite of statin-related myalgia, statin-related rhabdomyolysis, and creatine kinase above the upper limit of normal. Secondary outcomes included liver function tests above 3 times the upper limit of normal, statin discontinuation, and statin dose decrease and associated reason. Results: A total of 178 recipients were included, with 100 receiving low-to-moderate-intensity statins and 78 receiving high-intensity statins. There were no differences between groups for statin-related myalgia, and no reported cases of statin-related rhabdomyolysis in either group. Low to moderate intensity statin use was associated with an increased rate of liver function test elevation (26% vs 11.5%, P = .014) occurring a median of 306 days (interquartile range [IQR] 134-725) post-statin initiation. Conclusion: In liver and kidney transplant recipients receiving tacrolimus, the use of high-intensity statins was not associated with an increased risk of myalgia, rhabdomyolysis, or elevated creatinine kinase when compared with low-to-moderate-intensity statin use.
期刊介绍:
Progress in Transplantation (PIT) is the official journal of NATCO, The Organization for Transplant Professionals. Journal Partners include: Australasian Transplant Coordinators Association and Society for Transplant Social Workers. PIT reflects the multi-disciplinary team approach to procurement and clinical aspects of organ and tissue transplantation by providing a professional forum for exchange of the continually changing body of knowledge in transplantation.