Statin 的副作用？

Unintended Effects of Statin Drugs
Kidney failure and cataracts were associated significantly with statin use.

Statins lower risk for adverse cardiovascular events, especially in high-risk patients. In this large prospective U.K. cohort study, investigators sought to quantify unintended effects of these widely used drugs.

Of the more than 2 million study participants (age range, 30–84), about 225,000 were new statin users: 160,000 were prescribed simvastatin, 50,000 received atorvastatin, and 15,000 received pravastatin, rosuvastatin, or fluvastatin. Statin use was associated significantly with lower risk for esophageal cancer and higher risks for liver dysfunction (alanine transaminase levels 3x upper limit of normal), myopathy (clinical diagnosis or creatinine kinase level 4x upper limit of normal), acute kidney failure, and cataracts; liver dysfunction and acute kidney failure were dose-dependent. Adverse effects for individual statins were similar, except for liver dysfunction, in which risk was highest for fluvastatin. All excess risks persisted during treatment and returned to normal after drug cessation. Statin use was not associated with risk for osteoporotic fracture, venous thromboembolism, dementia, Parkinson disease, rheumatoid arthritis, or cancers (stomach, lung, breast, colon, kidney, and prostate cancers or melanoma).

Comment:

Most clinicians are familiar with statin-associated liver dysfunction and myopathy. The results of this study suggest that clinicians should be familiar with and monitor for two more possible statin-associated adverse effects: acute kidney failure and cataracts. In addition, with the exception of esophageal cancer risk, the results are consistent with those of a prior meta-analysis, in which researchers found no association between statin use and cancer risk (JW Cardiol Mar 9 2006).

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Paul S. Mueller, MD, MPH, FACP
Published in Journal Watch General Medicine June 15, 2010

Citation(s):
Hippisley-Cox J and Coupland C. Unintended effects of statins in men and women in England and Wales: Population based cohort study using the QResearch database. BMJ 2010 May 20; 340:c2197. (http://dx.doi.org/10.1136/bmj.c2197)