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https://www.readbyqxmd.com/read/29341524/-what-s-new-in-ambulatory-general-internal-medicine%C3%A2
#1
Annick Gerber, Camille Buffle Genecand, Thierry Mach, David Schrumpf, Ana Rita Forte Marques, Jean Dupraz, Thomas Schmid
Many treatments are used every day in general medicine without any evidence of their efficacy. This last year, three randomised studies tried to prove the clinical utility of chondroitin/glucosamine in arthritis, cranberry in urinary infections, and acupuncture in migraine. Screening and management of prostate cancer are still controversial. Two recent studies help us advising our patients on this difficult topic. Muscle side effects from statins are well known and have been widely relayed by the press these last years, although myopathies are rare in clinical trials...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29318532/management-of-statin-intolerance-in-2018-still-more-questions-than-answers
#2
REVIEW
Peter P Toth, Angelo Maria Patti, Rosaria Vincenza Giglio, Dragana Nikolic, Giuseppa Castellino, Manfredi Rizzo, Maciej Banach
Statin therapy is generally well tolerated and very effective in the prevention and treatment of cardiovascular disease, regardless of cholesterol levels; however, it can be associated with various adverse events (myalgia, myopathy, rhabdomyolysis, and diabetes mellitus, among others). Patients frequently discontinue statin therapy without medical advice because of perceived side effects and consequently increase their risk for cardiovascular events. In patients with statin intolerance, it may be advisable to change the dose, switch to a different statin, or try an alternate-day regimen...
January 9, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29278865/simvastatin-activates-single-skeletal-ryr1-channels-but-exerts-more-complex-regulation-of-the-cardiac-ryr2-isoform
#3
Elisa Venturi, Chris Lindsay, Sabine Lotteau, Zhaokang Yang, Emma Steer, Katja Witschas, Abigail D Wilson, James R Wickens, Angela J Russell, Derek Steele, Sarah Calaghan, Rebecca Sitsapesan
BACKGROUND AND PURPOSE: Statins are amongst the most widely prescribed drugs for those at risk of cardiovascular disease, lowering cholesterol levels by inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. Although effective in prevention of cardiovascular disease, statin use is associated with muscle weakness, myopathies and, in rare cases, fatal rhabdomyolysis. As simvastatin, a commonly prescribed statin, can promote Ca2+ release from sarcoplasmic reticulum (SR) vesicles, we investigated if simvastatin could directly activate skeletal (RyR1) and cardiac (RyR2) ryanodine receptors...
December 26, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29261630/18f-fdg-pet-ct-and-mri-in-necrotizing-autoimmune-myopathy-the-scarface-sign
#4
Coralie Pelissou, Nathalie Lerolle, Céline Labeyrie, Emmanuel Durand, Florent L Besson
Necrotizing autoimmune myopathy (NAM) is a relatively newly recognized subgroup of idiopathic inflammatory myopathies. The common histopathologic features are myocyte necrosis without significant inflammation. Necrotizing autoimmune myopathy can be associated with connective tissue disorders but can also be triggered by viral infections such as human immunodeficiency virus or malignancy, be statin-induced NAM, or be idiopathic. Here, the authors present the case of a 58-year-old man who was referred to our PET unit for a suspected paraneoplastic syndrome in a context of NAM...
December 19, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29197834/study-protocol-for-statin-web-based-investigation-of-side-effects-statinwise-a-series-of-randomised-controlled-n-of-1-trials-comparing-atorvastatin-and-placebo-in-uk-primary-care
#5
Emily Herrett, Elizabeth Williamson, Danielle Beaumont, Danielle Prowse, Nabila Youssouf, Kieran Brack, Jane Armitage, Ben Goldacre, Thomas MacDonald, Tjeerd van Staa, Ian Roberts, Haleema Shakur-Still, Liam Smeeth
INTRODUCTION: Statins are effective at preventing cardiovascular disease, widely prescribed and their use is growing. Uncertainty persists about whether they cause symptomatic muscle adverse effects, such as pain and weakness, in the absence of statin myopathy. Discrepancies between data from observational studies, which suggest statins are associated with excess muscle symptoms, and from randomised trials, which suggest no such excess, have caused confusion. N-of-1 trials offer the opportunity to establish whether muscle symptoms during statin use are caused by statins in particular individuals...
December 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/29179650/statin-related-adverse-effects-and-patient-education-a-study-from-resource-limited-settings
#6
Rubina Mulchandani, Tanica Lyngdoh, Praloy Chakraborty, Ashish Kumar Kakkar
BACKGROUND: Statins are the most widely prescribed class of drugs for coronary artery disease (CAD) patients and yet literature on the prevalence of statin related adverse effects (AEs) and gaps in patient education is quite limited especially in resource-limited settings of developing world. OBJECTIVES: The present study was conducted to determine the prevalence of myopathy (muscle ailments) and other statin associated adverse effects among CAD patients on statin therapy...
November 27, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29067242/impact-of-vitamin-d-status-on-statin-induced-myopathy
#7
Krista D Riche, Justin Arnall, Kristin Rieser, Honey E East, Daniel M Riche
INTRODUCTION: There is a multitude of evidence supporting the benefit of statin use in cardiovascular disease; however, statin-induced myopathy is a major reason for statin discontinuation and non-adherence. Vitamin D deficiency has been independently associated with muscle weakness and severe myopathy, and may be a confounder for statin-induced myopathies. Since there is no consensus on a treatment course of action for statin-induced myopathy, investigation into potential confounders to elucidate the dynamics of statin-induced myopathy is warranted...
December 2016: Journal of Clinical & Translational Endocrinology
https://www.readbyqxmd.com/read/29058944/statin-drug-interactions-and-related-adverse-reactions-an-update
#8
Stefano Bellosta, Alberto Corsini
Statins reduce the risk of cardiovascular morbidity and mortality in patients with or at risk for cardiovascular disease and their use is expanding, especially in elderly. Statins are prescribed on a long-term basis and may undergo drug-drug interactions (DDIs) with other drugs. Statins have different safety and tolerability, and this might affect the possibility of DDIs with other cardiovascular drugs, increasing the risk of statin-associated myopathy and hepatotoxicity. Polypharmacy and pharmacogenetic variability are potential causes of statin DDIs...
October 30, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29056268/successful-treatment-of-a-patient-with-statin-induced-myopathy-and-myotonic-dystrophy-type-ii-with-proprotein-convertase-subtilisin-kexin-type-9-inhibitor-alirocumab-praluent
#9
Mohamed K M Shakir, Terry Shin, Thanh D Hoang, Vinh Q Mai
Presently there are limited treatment options for hypercholesterolemia in patients with statin intolerance and myotonic dystrophy. A 74 year-old male presented to endocrine clinic with hypercholesterolemia (serum LDL-C 210 mg/dL), hypogonadism, insulin-controlled type 2 diabetes mellitus, and minimally elevated serum creatine kinase (CK) levels (184 U/L, ref. range 38-174). Shortly after simvastatin treatment, patient developed severe myalgias in the proximal lower and upper extremities; and serum CK increased to 317 U/L...
September 4, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29040646/statins-affect-skeletal-muscle-performance-evidence-for-disturbances-in-energy-metabolism
#10
Neeltje A E Allard, Tom J J Schirris, Rebecca J Verheggen, Frans G M Russel, Richard J Rodenburg, Jan A M Smeitink, Paul D Thompson, Maria T E Hopman, Silvie Timmers
Context: Statin myopathy is linked to disturbances in mitochondrial function and exercise intolerance. Objectives: To determine whether differences exist in exercise performance, muscle function and mitochondrial oxidative capacity and content between symptomatic and asymptomatic statin users, and non-statin using controls. Design: Cross-sectional study. Setting: Department of Physiology of the Radboud University Medical Center...
October 9, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29020356/a-common-missense-variant-of-lilrb5-is-associated-with-statin-intolerance-and-myalgia
#11
Moneeza K Siddiqui, Cyrielle Maroteau, Abirami Veluchamy, Aleksi Tornio, Roger Tavendale, Fiona Carr, Ngu-Uma Abelega, Dan Carr, Katyrzyna Bloch, Par Hallberg, Qun-Ying Yue, Ewan R Pearson, Helen M Colhoun, Andrew D Morris, Eleanor Dow, Jacob George, Munir Pirmohamed, Paul M Ridker, Alex S F Doney, Ana Alfirevic, Mia Wadelius, Anke-Hilse Maitland-van der Zee, Daniel I Chasman, Colin N A Palmer
Aims: A genetic variant in LILRB5 (leukocyte immunoglobulin-like receptor subfamily-B) (rs12975366: T > C: Asp247Gly) has been reported to be associated with lower creatine phosphokinase (CK) and lactate dehydrogenase (LDH) levels. Both biomarkers are released from injured muscle tissue, making this variant a potential candidate for susceptibility to muscle-related symptoms. We examined the association of this variant with statin intolerance ascertained from electronic medical records in the GoDARTS study...
August 29, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019063/statin-prescribing-in-the-elderly-special-considerations
#12
REVIEW
M Leya, N J Stone
PURPOSE OF REVIEW: Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinicians must more carefully consider adverse effects and drug-drug interactions before prescribing statin therapy as well as determining the intensity in older individuals...
October 11, 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28994502/pro-protein-subtilisin-kexin-9-pcsk9-inhibition-in-practice-lipid-clinic-experience-in-2-contrasting-uk-centres
#13
Monika Kohli, Kinjal Patel, Zofia MacMahon, Radha Ramachandran, Martin A Crook, Timothy M Reynolds, Anthony S Wierzbicki
BACKGROUND: Prescribing criteria have been suggested for proprotein convertase subtilisin kexin-9 (PCSK-9) inhibitors but few studies exist of their real-world effectiveness. METHODS: This study audited PCSK-9 inhibitor therapy in 105 consecutive patients from two hospital centres-a university hospital (UH; n = 70) and a district general hospital (DGH; n = 35). Baseline characteristics including cardiovascular disease risk factors, NICE qualification criteria, efficacy and side effects were assessed...
November 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28976376/-dyslipidaemias-in-elderly-patients
#14
Aytül Belgi Yıldırım, Ali Yaşar Kılınç
Statin use in people over 65 years of age is high. A meta-analysis of older patients included in randomised trials found good evidence that statins reduce vascular events and mortality in people with existing coronary heart disease. In older adults, exposure to higher doses of statins or higher potency statins does not increase their effectiveness, but does increase the risk of adverse effects such as myopathy and cognitive impairment. Increasing age is a risk factor for adverse events with statins. Older patients may be less resilient to these effects...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28963307/statin-associated-muscle-symptoms-sams-in-primary-prevention-for-cardiovascular-disease-in-older-adults-a-protocol-for-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#15
Zhen Zhou, Loai Albarqouni, Monique Breslin, Andrea J Curtis, Mark Nelson
INTRODUCTION: Although statins are commonly used for prevention of cardiovascular disease, there is limited evidence about statin-related adverse effects in older people. Statin-related adverse events (AEs), especially the statin-associated muscle symptoms (SAMS), are the most common reasons for their discontinuation. Therefore, it is important to determine the risk of SAMS in the older population. We will undertake a systematic review and meta-analysis primarily focusing on the risk of SAMS and secondarily targeting myopathy, rhabdomyolysis, AEs and serious AEs, dropouts due to SAMS in run-in period, related permanent discontinuation rate of statins and creatine kinase level, among older people who received statins for primary prevention...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28959671/a-severe-myopathy-case-in-aged-patient-treated-with-high-statin-dosage
#16
Canzonieri Elena, De Candia Cristina, Tarascio Salvatore, Giamporcaro Silvia, Lumera Giovanni, Rigano Giuseppe, Incognito Carmela, Privitera Filippo, Guarnaccia Agata, Foti Pietro Valerio, Palmucci Stefano, Gangemi Pietro, Fuccio-Sanzà Giulia, Signorelli Salvatore Santo
Statins (S) are widely used drugs for cardiovascular prevention however their utilization may cause a various grade of muscle toxicity. Sometime S discontinuation alone is not sufficient to revert muscle injury and this can evolve in serious inflammatory muscle disease. In this case immunosuppressive medications are required to achieve remission. This case report describes a patient who developed rhabdomyolysis after recent S treatment initiation and the diagnostic work up have lead to the diagnosis of necrotizing autoimmune myopathy (NAM)...
2017: Toxicology Reports
https://www.readbyqxmd.com/read/28952474/-pitavastatin-tolerability-and-advers-effect-profile
#17
Nevrez Koylan
There are many speculations about the safety of statins which are widely used drugs. In contrast, statins are safer than many widely used drugs. Rhabdomyolysis, the most important adverse event is closely related to plasma drug levels which take drug interactions into account. The most important drugs among interacting drugs are fibrates, antiretroviral drugs and macrolid antibiotics, and, pitavastatin seems to be more advantageous than other statins. Similarly, pitavastatin has better myopathy profile when compared to other statins...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28951665/prevalence-of-potential-drug-interactions-in-thai-patients-receiving-simvastatin-the-causality-assessment-of-musculoskeletal-adverse-events-induced-by-statin-interaction
#18
Methira Siriangkhawut, Patthana Tansakul, Verawan Uchaipichat
Drug-drug interactions are one of the major risk factors associated with statin-induced myopathy. Although simvastatin is widely used in Thailand, studies investigating the prevalence of potential simvastatin-drug interactions (SDIs) and its clinical relevance in Thai population are still limited. We aimed to investigate the prevalence of potential SDIs (phase 1 study) and musculoskeletal adverse effects (AEs) associated with those interactions (phase 2 study). A phase 1 study was retrospectively conducted with outpatients at a 60-bed hospital who received simvastatin between July 1, 2012 and June 30, 2013...
September 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28940218/genetic-and-clinical-factors-are-associated-with-statin-related-myotoxicity-of-moderate-severity-a-case-control-study
#19
Nur Salwani Bakar, Dermot Neely, Peter Avery, Colin Brown, Ann K Daly, Farhad Kamali
We evaluated the contribution of patient specific clinical and genetic factors to statin-related muscle toxicity (SRM) without significant creatine kinase elevation (125 cases related to simvastatin or atorvastatin and 481 controls). The association between 12 SNPs in nine candidate genes and clinical factors with SRM was evaluated. Of the 12 SNPs genotyped, only rs4149056 in SLCO1B1 was associated with SRM in univariate analysis (with any statin, OR=1.73, 95% CI= 1.14-2.62, P = 0.010) and this association was influenced by sex (P= 0...
September 22, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28905130/clinico-serologic-features-of-statin-induced-necrotising-autoimmune-myopathy-in-a-single-centre-cohort
#20
Michael J Waters, Vidya Limaye
Statin-induced necrotising autoimmune myopathy (NAM) is a rare but disabling complication of statin therapy. Data regarding treatment and outcomes in these patients is sparse. We retrospectively identified those patients with a diagnosis of statin-induced NAM who were managed in a single-tertiary referral centre from January 2014 to January 2017. Data regarding clinical features, serology, antibody status and functional outcome was collected. We identified 16 patients diagnosed with statin-induced NAM. Truncal weakness was present in 9/16 patients, of which one patient presented with camptocormia...
September 13, 2017: Clinical Rheumatology
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