Source:http://linkedlifedata.com/resource/pubmed/id/18533086
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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
6
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pubmed:dateCreated |
2008-6-5
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pubmed:abstractText |
Myalgia, which often manifests as pain or soreness in skeletal muscles, is among the most salient adverse events associated with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins). Clinical issues related to statin-associated myotoxicity include (1) incidence in randomized controlled trials and occurrence in postmarketing surveillance databases; (2) potential differences between statins in their associations with such adverse events; and (3) diagnostic and treatment strategies to prevent, recognize, and manage these events. Data from systematic reviews, meta-analyses, clinical and observational trials, and post-marketing surveillance indicate that statin-associated myalgia typically affects approximately 5.0% of patients, as myopathy in 0.1% and as rhabdomyolysis in 0.01%. However, studies also suggest that myalgia is among the leading reasons patients discontinue statins (particularly high-dose statin monotherapy) and that treatment with certain statins (eg, fluvastatin) is unlikely to result in such adverse events. This review presents a clinical algorithm for monitoring and managing statin-associated myotoxicity. The algorithm highlights risk factors for muscle toxicity and provides recommendations for (1) creatine kinase measurements and monitoring; (2) statin dosage reduction, discontinuation, and rechallenge; and (3) treatment alternatives, such as extended-release fluvastatin with or without ezetimibe, low-dose or alternate-day rosuvastatin, or ezetimibe with or without colesevelam. The algorithm should help to inform and enhance patient care and reduce the risk of myalgia and other potentially treatment-limiting muscle effects that might undermine patient adherence and compromise the overall cardioprotective benefits of statins.
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pubmed:commentsCorrections | |
pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Jun
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pubmed:issn |
1942-5546
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pubmed:author | |
pubmed:issnType |
Electronic
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pubmed:volume |
83
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
687-700
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pubmed:dateRevised |
2010-11-18
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pubmed:meshHeading |
pubmed-meshheading:18533086-Algorithms,
pubmed-meshheading:18533086-Clinical Trials as Topic,
pubmed-meshheading:18533086-Creatine Kinase,
pubmed-meshheading:18533086-Fibromyalgia,
pubmed-meshheading:18533086-Humans,
pubmed-meshheading:18533086-Hydroxymethylglutaryl-CoA Reductase Inhibitors,
pubmed-meshheading:18533086-Kaplan-Meier Estimate,
pubmed-meshheading:18533086-Meta-Analysis as Topic,
pubmed-meshheading:18533086-Product Surveillance, Postmarketing,
pubmed-meshheading:18533086-Rhabdomyolysis,
pubmed-meshheading:18533086-Risk Factors
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pubmed:year |
2008
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pubmed:articleTitle |
Toward "pain-free" statin prescribing: clinical algorithm for diagnosis and management of myalgia.
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pubmed:affiliation |
Office of Health Promotion and Disease Prevention, Emory University, Faculty Office Building, 49 Jessie Hill Jr Dr SE, Atlanta, GA 30303, USA. tjaco02@emory.edu
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pubmed:publicationType |
Journal Article,
Review
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