Abstract

Aim. To evaluate the risk of muscle tissue damage in patients taking statins, and usefulness of the gene SLCO1B1 typifying for the risk estimation of such an unpleasant adverse drug reaction (ADR). Material and methods. The observation of 258 patients with ischemic heart disease, taking statins, was conducted. To evaluate the credibility of causeoutcome relation “ADR – statin” the WHO classifications and criteria were used together with Naranjo algorithm. Results. The 3 groups were stratified: I – patients with muscle pain or weakness and with probable to definite chance of the cause-outcome relation (n=31); II – patients with muscle symptoms and possible or doubtful degree of credibility for causeoutcome relation (n=27); III – patients without muscle symptoms (n=200); of those into further study we included 35 subjects. Among those with muscle symptoms women were more prevalent (I group – 61,3% (19/35); (p>0,05 in all groups). Mean time of hypolipidemic therapy of 1st group patients was 48,8 months (p 0,9999). The algorithm for statin-induced myopathy was invented. Conclusion. In patients with CHD the ADR as myopathy were found in 12% of cases. The most significant predictors: duration of hypolipidemic therapy more than12 months (RR 7,7; p=0,0002), atorvastatin usage in dose more than 40 mg per day (RR 2,67, p=0,0139). The prevalence of statin-associated muscle events was higher in women (RR 1,88, p=0,23) and carriers of allele type SLCO1B1*5 (RR 2,37; p=0,0732).

Highlights

  • Н. — к.м.н., ассистент кафедры клинической фармакологии и интенсивной терапии, руководитель регионального центра мониторинга безопасности лекарственных средств, Соловкина Ю

  • В.* — к.м.н., ассистент кафедры клинической фармакологии и интенсивной терапии, Шаталова О

  • В. — к.м.н., докторант кафедры клинической фармакологии и интенсивной терапии

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Summary

Introduction

ВОЗ — Всемирная организация здравоохранения, ДИ — доверительный интервал, КК — креатинкиназа, НЛР — нежелательная лекарственная реакция, ОШ — отношение шансов. THE SLCO1B1 GENE POLYMORPHISM AND STATIN-INDUCED MYOPATHY IN RUSSIAN PATIENTS Исследование SEARCH 2008 года продемонстрировало связь между носительством аллельного варианта SLCO1B1*5 и высокой частотой развития статин-индуцированной миопатии в (60% случаев при применении статинов в высоких дозах) [5].

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