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1.
《Saudi Pharmaceutical Journal》2022,30(10):1486-1496
IntroductionPreclinical studies have demonstrated the possible anticancer effects of statins, but the synergistic effect of concomitant statin use with standard chemotherapy protocols in patients with breast cancer has not yet been investigated.AimThe current study aimed to evaluate the efficacy of concomitant pitavastatin use with neoadjuvant chemotherapy protocols in patients with breast cancer.MethodsThis study was a randomized controlled clinical trial. A total of 70 adult female patients with pathologically-proven invasive breast cancer were randomized to receive or not receive pitavastatin (2 mg) oral tablets once daily concomitantly with standard neoadjuvant chemotherapy protocols for 6 months. The primary outcomes of this study were changes in tumor size and changes to the Ki67 index. In addition, secondary outcomes were changes in cyclin D1 and cleaved caspase-3 serum levels. This study was registered at ClinicalTrials.gov (Identifier: NCT04705909).ResultsPatients in the pitavastatin group showed significantly higher median (IQR) reductions in tumor size [?19.8 (?41.5, 9.5)] compared to those in the control group [?5.0 (?15.5, 0.0), p = 0.0009]. The change in Ki67 from baseline to the end of therapy was similar between the two groups (p = 0.12). By the end of therapy, the cyclin D1 levels in the pitavastatin group were significantly decreased [median (IQR) change of ? 10.0 (?20.2, ?2.9) from baseline], whereas the control group showed an increase in cyclin D1 levels [14.8 (4.1, 56.4)]. The median (IQR) caspase?3 was elevated in the pitavastatin group 1.6 (0.2, 2.2), and decreased in the control group (?0.2 (?1.1, 0.0), p = 0.0002).Subgroup analysis of the pitavastatin group revealed that patients with positive human epidermal growth receptor 2 (HER2) had higher median (IQR) reductions in Ki67 [?35.0 (?70.0, ?12.5)] than those with negative HER2 [2.5 (?15.0, 10.0), p = 0.04]. All patients who achieved a complete pathological response (n = 9) exhibited an HER2-neu positive receptor at baseline.ConclusionConcomitant use of pitavastatin with standard neoadjuvant chemotherapy protocols may improve neoadjuvant chemotherapy responses in patients with breast cancer.  相似文献   
2.
Atrial fibrillation is the most common arrhythmia in adults and its prevalence is growing rapidly. It has been shown that AF is associated with increased risk of heart failure, ischemic and hemorrhagic stroke, and mortality. Hence, there is growing interest among researchers in seeking preventive and therapeutic interventions regarding AF. In recent decades, it has been suggested that statins may decrease the incidence of AF and may also decrease its recurrence after cardioversion and catheter ablation. These effects are thought to be mediated by different mechanisms such as modulating inflammation, altering the properties of transmembrane ion channels, interfering with activation of matrix metalloproteinases, and acting on endothelial function. In this article, we review and update current knowledge about the role of statins in primary and secondary prevention of AF in general and specific populations.  相似文献   
3.
目的:探讨他汀类药物致过敏反应发生的特点和规律,为临床合理用药提供参考。方法:选取2015年1月至2021年3月该院不良反应监测网上报的他汀类药物致过敏反应病例,同时检索2000年1月至2021年3月中国知网、万方数据库和维普数据库收录的他汀类药物致过敏反应文献,对病例进行统计分析。结果:该院上报他汀类药物致过敏反应4例,检索文献获得他汀类药物致过敏反应的个案报道26篇(26例),共30例;其中男性患者19例(占63.33%),女性患者11例(占36.67%);患者年龄为32~85岁,平均年龄为61.4岁;过敏反应发生时间最短为口服后5 min,最长为连续口服6个月,其中17例(占56.67%)发生于用药后≤3 d;过敏反应包括皮肤过敏(19例)、过敏性休克(3例)、血管神经性水肿(5例)、药物热(2例)和过敏性哮喘(1例);5例(占16.67%)报告了更换其他调节血脂药替代治疗方案。结论:他汀类药物可导致休克、血管神经性水肿和过敏性哮喘等过敏反应,用药时应注意患者的用药监护,特别是首次用药初期;出现不良反应,应及时上报;对于应用他汀类药物利大于弊的患者,应阐明发生过敏反应时的替代治疗方案,为临床用药提供参考。  相似文献   
4.
BackgroundTrial and observational evidence is conflicting in terms of the association of blood lipids, atherosclerosis and statin use with dementia and cognitive impairment in the general population. It is uncertain whether the associations occur in stroke patients, who are at known higher risk of cognitive decline. This systematic review was to synthesize the evidence for these associations among stroke patients.MethodsMEDLINE, EMBASE, the Cochrane Library and trial registries were searched. We included randomized controlled trials (RCTs) or observational cohort studies conducted among patients with stroke and reported on the association of blood lipids, atherosclerosis or statin use with dementia or cognitive impairment. Meta-analysis was conducted separately for crude and maximally adjusted odds ratios (ORs) and hazard ratios (HRs).ResultsOf 18,026 records retrieved, 56 studies (one RCT and 55 cohort studies) comprising 38,423 stroke patients were included. For coronary heart disease, the pooled OR of dementia and cognitive impairment was 1.32 (95%CI 1.10–1.58, n = 15 studies, I2 = 0%) and 1.23 (95%CI 0.99–1.54, n = 14, I2 = 26.9%), respectively. Peripheral artery disease was associated with dementia (OR 3.59, 95%CI 1.47–8.76, n = 2, I2 = 0%) and cognitive impairment (OR 2.70, 95%CI 1.09–6.69, n = 1). For carotid stenosis, the pooled OR of dementia and cognitive impairment was 2.67 (95%CI 0.83–8.62, n = 3, I2 = 77.9%) and 3.34 (95%CI 0.79–14.1, n = 4, I2 = 96.6%), respectively. For post-stroke statin use, the pooled OR of dementia and cognitive impairment was 0.89 (95%CI 0.65–1.21, n = 1) and 0.56 (95%CI 0.46-0.69, n = 3, I2 = 0%), respectively. No association was observed for hypercholesterolemia. These results were mostly consistent with adjusted ORs or HRs, which were reported from limited evidence.ConclusionAtherosclerosis was associated with an increased risk of post-stroke dementia. Post-stroke statin use was associated with decreased risk of cognitive impairment. To confirm whether or not statins confer advantages in the post-stroke population in terms of preventing cognitive decline over and above their known effectiveness in reducing risk of further vascular events, further stroke trials including cognitive assessment and observational analyses adjusted for key confounders, focusing on key subgroups or statin use patterns are required.  相似文献   
5.
Statins are lipid-lowering medications widely used to reduce the risk of cardiovascular diseases. Biochemically, they act by decreasing synthesis of cholesterol via inhibiting 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase. Since 1992, various research studies have investigated the effect of statins on semen quality characteristics; however, to date, there is no collective summary to such effect. Here, we have systematically discussed and abridged all research studies published in Scopus, PubMed and Web of Science databases that are directly linking statin to semen fertility characteristics using the keywords “statin” versus “sperm” and “semen”. In summary, considering the animal studies, statins, in general, were found to ameliorate semen quality characteristics in reproductive detrimental conditions, while, in human males or in in vivo systems with normal reproductive conditions, in general, statins showed negative to blunt effects against semen quality characteristics, mainly sperm motility. However, further research studies, in particular human studies, in this specific research setting is still needed to approve these effects.  相似文献   
6.
吴军 《药品评价》2020,(1):24-25,53
他汀类药物在我国临床上应用非常广泛,被认作是降低血清胆固醇指标效果最好的药物,除了调节脂质外,还有其他非脂质的调节功能让患者受益,如抗炎作用、抗氧化作用、抗栓作用、调节免疫作用、保护神经作用、改善内皮功能作用等等。当前他汀类药物较多地应用在心血管疾病以及肾脏疾病的临床治疗工作中,均得益于该药物实用的药理作用以及应用下患者产生的不良反应较少,安全性与可靠性得到保障。本文整理总结他汀类药物临床应用的效果与机制,形成以下综述。  相似文献   
7.
《Reumatología clinica》2022,18(5):266-272
BackgroundDifferent strategies have been proposed for the cardiovascular risk management of patients with rheumatoid arthritis (RA).Objectives(1) To estimate the cardiovascular risk by different strategies in RA patients, analyzing which proportion of patients would be candidates to receive statin therapy; (2) to identify how many patients meet the recommended lipid goals.MethodsA cross-sectional study was performed from a secondary database. The QRISK-3 score, the Framingham score (adjusted for a multiplying factor × 1.5), the ASCVD calculator and the SCORE calculator were estimated. The indications for statin therapy according to NICE, Argentine Consensus, ACC/AHA, and new European guidelines were analyzed. The recommended LDL-C goals were analyzed.ResultsA total of 420 patients were included. In total, 24.7% and 48.7% of patients in primary and secondary prevention were receiving statins, respectively. Only 19.4% of patients with cardiovascular history received high intensity statins. Applying the ACC/AHA guidelines (based on ASCVD score), the Argentine Consensuses (based on adjusted Framingham score), the NICE guidelines (based on QRISK-3) and European recommendations (based on SCORE), 26.9%, 26.5%, 41.1% and 18.2% of the population were eligible for statin therapy, respectively. Following the new European recommendations, 50.0%, 46.2% and 15.9% of the patients with low-moderate, high or very high risk achieved the suggested lipid goals.ConclusionApplying four strategies for lipid management in our population, the cardiovascular risk stratification and the indication for statins were different. A significant gap was observed when comparing the expected and observed statin indication, with few patients achieving the LDL-C goals.  相似文献   
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9.
目的 探讨他汀类药物相关肌病(简称他汀肌病)的临床特点及骨骼肌病理改变特点.方法 分析2012年4月至2014年10月就诊于北京大学第一医院并行肌肉活检的9例他汀肌病患者的临床及病理资料.结果 9例患者均口服他汀类药物4d至4年,就诊年龄55 ~74(63 ±6)岁,其中男6例,女3例.3例出现肌痛,6例出现四肢近端为主的肌无力,3例无任何临床症状.所有患者血清肌酸激酶(CK)升高(468 ~8 000 U/L).7例患者行血清肌炎抗体检查,均阴性.6例患者行肌电图检查,2例出现肌源性损害.6例患者行双侧大腿骨骼肌MRI检查,其中2例显示有部分肌群水肿及轻度脂肪化.骨骼肌活检病理主要表现:肌纤维萎缩、坏死、再生、脂肪滴增多,部分患者出现破碎蓝纤维、细胞色素c氧化酶阴性肌纤维及还原型辅酶Ⅰ四氮唑还原酶活性降低,主要组织相容性复合物-Ⅰ在肌纤维膜不同程度表达,补体C5b-9染色显示肌内衣、胞质以及毛细血管少量补体沉积.随访发现,多数(7例)患者停用他汀类药物或换用其他他汀类药物后,症状及CK水平改善,仅2例患者需应用免疫抑制治疗且有效.结论 本组患者中多数(7例)他汀肌病为自限性,停用他汀类药物后可自行好转,个别患者(2例)可出现免疫性坏死性肌肉病,需要应用免疫抑制治疗.  相似文献   
10.
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