1
|
Taherkhani M, Khanifar Z, Taherkhani A, Hajishah H, Tavasol A. Assessing the effect of high-dose rosuvastatin in elderly patients over 75 with acute coronary syndrome. BMC Cardiovasc Disord 2024; 24:474. [PMID: 39243009 PMCID: PMC11378640 DOI: 10.1186/s12872-024-04142-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUNDS AND OBJECTIVE Statins, inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductase, are pivotal in managing hypercholesterolemia and reducing cardiovascular risk. While rosuvastatin demonstrates superior efficacy and tolerability compared to other statins, its safety profile in elderly patients older than 75 years old with acute coronary syndrome (ACS) remains underexplored. So, the objective of this study is to evaluate the frequency of adverse reactions and investigate the efficacy of high-dose rosuvastatin on lipid profiles in elderly patients aged over 75 with ACS. METHODS In this observational study, 110 consecutive elderly ACS patients attending Modarres Hospital in Tehran, Iran, in 2019 were enrolled. The effects of high-dose rosuvastatin were assessed in elderly patients older than 75 years old by comparison of the adverse effects, lipid profile, cardiac function, and other biomarkers at the baseline and after 6 weeks of rosuvastatin therapy with a dose of 40 mg. RESULTS Following 6 weeks of treatment, there was a significant reduction in total cholesterol (136.2 ± 24.3 to 115.5 ± 24.0, p = 0.001) and LDL levels (72.6 ± 17.5 to 50.9 ± 18.9, p = 0.001), accompanied by a notable increase in HDL levels (38.3 ± 7.1 to 47.2 ± 7.4, p = 0.001). Cardiac function, as measured by ejection fraction (EF), significantly improved from 43.4 ± 8.8 to 48.5 ± 8.5 (p = 0.001). Adverse effects such as cramps (N = 12, p = 0.001), weakness (N = 28, p = 0.001), and anorexia (N = 12, p = 0.001) were reported but did not warrant discontinuation of therapy. Notably, no cases of jaundice were observed. Two deaths occurred due to major adverse cardiac events (MACE) during the study period, unrelated to stroke or recurrent myocardial infarction. CONCLUSION Totally, high-dose rosuvastatin therapy effectively improved lipid profiles, cardiac function, and liver enzyme levels in elderly ACS patients, with manageable adverse effects. These findings underscore the importance of rosuvastatin in optimizing cardiovascular health in this vulnerable population.
Collapse
Affiliation(s)
- Maryam Taherkhani
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeinab Khanifar
- Department of Cardiology, Ahvaz Jundishapur University of Medical Sciences, Shoush, Iran
| | - Adineh Taherkhani
- Department of Gastroenterology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Hajishah
- Student Research Committee, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Arian Tavasol
- Student Research Committee, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Li L, Wang H, Zhang S, Gao S, Lu X, Pan Y, Tang W, Huang R, Qiao K, Ning S. Statins inhibit paclitaxel-induced PD-L1 expression and increase CD8+ T cytotoxicity for better prognosis in breast cancer. Int J Surg 2024; 110:4716-4726. [PMID: 39143707 PMCID: PMC11325938 DOI: 10.1097/js9.0000000000001582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 04/25/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND In recent years, the widespread use of lipid-lowering drugs, especially statins, has attracted people's attention. Statin use may be potentially associated with a reduced risk of breast cancer. OBJECTIVE To explore the relationship between statin use and cancer risk. And further explore the potential role of statins in the adjuvant treatment of breast cancer. METHODS Data for the Mendelian randomization portion of the study were obtained from genome-wide association studies of common cancers in the UK Biobank and FinnGen studies and from the Global Lipid Genetics Consortium's low density lipoprotein (LDL). In addition, the impacts of statins and chemotherapy drugs on breast cancer were examined using both in vitro and in vivo models, with particular attention to the expression levels of the immune checkpoint protein PD-L1 and its potential to suppress tumor growth. RESULTS Data from about 3.8 million cancer patients and ~1.3 million LDL-measuring individuals were analyzed. Genetically proxied HMGCR inhibition (statins) was associated with breast cancer risk reduction (P=0.0005). In vitro experiments showed that lovastatin significantly inhibited paclitaxel-induced PD-L1 expression and assisted paclitaxel in suppressing tumor cell growth. Furthermore, the combination therapy involving lovastatin and paclitaxel amplified CD8+ T-cell infiltration, bolstering their tumor-killing capacity and enhancing in vivo efficacy. CONCLUSION The utilization of statins is correlated with improved prognoses for breast cancer patients and may play a role in facilitating the transition from cold to hot tumors. Combination therapy with lovastatin and paclitaxel enhances CD8+ T-cell activity and leads to better prognostic characteristics.
Collapse
Affiliation(s)
- Lei Li
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Hongbin Wang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Shiyuan Zhang
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Song Gao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Xiuxin Lu
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - You Pan
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning
| | - Wei Tang
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning
| | - Rong Huang
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning
| | - Kun Qiao
- Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Shipeng Ning
- Department of Breast Surgery, The Second Affiliated Hospital of Guangxi Medical University, Nanning
| |
Collapse
|
3
|
El-Kerdasy HI, Faruk EM, Hassan DAA, Nafea OE, Ibrahim F, Bagabir RA, Anwer HM, Allam AM. Rosuvastatin repurposing for prophylaxis against ethanol-induced acute gastric ulceration in rats: a biochemical, histological, and ultrastructural perspective. Inflammopharmacology 2024:10.1007/s10787-024-01513-z. [PMID: 39044068 DOI: 10.1007/s10787-024-01513-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/12/2024] [Indexed: 07/25/2024]
Abstract
Ethanol (EtOH) consumption is frequently associated with acute and chronic gastrointestinal disorders. Rosuvastatin (RSV), a third-generation statin, has demonstrated certain biological functions beyond its lipid-lowering properties. This study is designed to explore the gastroprotective impact of RSV in a rat model of EtOH-induced gastric ulceration in a dose-dependent manner through the evaluation of oxidant/antioxidant biomarkers, inflammatory myeloperoxidase (MPO) enzyme activity, and prostaglandin E2 (PGE2) levels in gastric tissues, along with histopathological examination of the gastric tissues. Therefore, 40 adult male rats were randomly divided into five equal groups as control, EtOH (gastric ulcer), RSV-low dose plus EtOH and RSV-high dose plus EtOH. The EtOH rat model of gastric ulceration was achieved by intragastric administration of a single dose of EtOH. Seven days before EtOH administration, rats were orally administered either omeprazole (20 mg/kg/day) or RSV (10 mg/kg/day or 20 mg/kg/day). RSV administration enhanced the antioxidant glutathione reduced, countered oxidative malondialdehyde, augmented cytoprotective PGE2, suppressed inflammatory MPO enzyme activity in gastric tissues, decreased ulcer index scoring, increased the percentage of ulcer inhibition, and reversed the associated histological and ultrastructural abnormalities, additionally, RSV treatment resulted in weak positive nuclear staining for the inflammatory nuclear factor kappa B in a dose-dependent manner. It is concluded that RSV demonstrates gastroprotective potential, attributable at least in part, to its antioxidant and anti-inflammatory properties, as well as its ability to promote ulcer protection through the maintenance of mucosal content and PGE2 levels. Thus, RSV therapy emerges as a safe option for patients with gastric ulcers.
Collapse
Affiliation(s)
- Hanan I El-Kerdasy
- Department of Anatomy and Embryology, Faculty of Medicine, Benha University, Benha, 13518, Egypt
| | - Eman Mohamed Faruk
- Anatomy Department, College of Medicine, Umm Al-Qura University, 24230, Makkah, Saudi Arabia
- Department of Histology and Cell Biology, Faculty of Medicine, Benha University, Benha, 13518, Egypt
| | - Dina Allam Abdelmaksoud Hassan
- Department of Histology and Cell Biology, Faculty of Medicine for Girls (AFMG), Al-Azhar University, Nasr CityCairo, 11884, Egypt
| | - Ola Elsayed Nafea
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt.
| | - Fatma Ibrahim
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Rania Abubaker Bagabir
- Hematology and Immunology Department, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hala Magdy Anwer
- Physiology Department, Faculty of Medicine, Benha University, Benha, 13518, Egypt
| | - Amany M Allam
- Department of Anatomy and Embryology, Faculty of Medicine, Benha University, Benha, 13518, Egypt
- Department of Anatomy, Physiology and Biochemistry, Faculty of Medicine, The Hashemite University, P.O. Box 330127, Zarqa, 13133, Jordan
| |
Collapse
|
4
|
Korzec J, Strausbaugh R, Mikolay JJ, Churchwell MD. Rhabdomyolysis and acute kidney injury potentiated by a drug-drug interaction between cyclosporine, leflunomide, and rosuvastatin in a kidney transplant recipient: A missed opportunity for pharmacist involvement. J Am Pharm Assoc (2003) 2024; 64:102016. [PMID: 38272309 DOI: 10.1016/j.japh.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND This study aimed to describe a case of rhabdomyolysis and acute kidney injury potentiated by a drug-drug interaction (DDI) between cyclosporine, leflunomide, and rosuvastatin in a kidney transplant recipient. CASE SUMMARY A 74-year-old male with end-stage kidney disease secondary to type 2 diabetes mellitus and hypertension received a deceased by cardiac death kidney transplant. The patient's medical history included coronary artery disease and hyperlipidemia for which he was receiving rosuvastatin 40 mg daily. Five months after transplant, the patient developed BK viremia, which required multiple changes in immunosuppression and resulted in the initiation of leflunomide and cyclosporine modified. The patient used multiple pharmacies and coupon cards that delayed the identification of the DDIs between leflunomide, cyclosporine, and rosuvastatin. Approximately, 13 months after transplant, the biopsy report of the patient's allograft kidney showed acute cellular rejection Banff IB, hypertensive changes, and transplant glomerulopathy. This prompted the patient to receive a 3-day course of methylprednisolone 250 mg intravenous at the outpatient infusion center. Two weeks later, the patient presented to the transplant clinic with lightheadedness, dizziness, weakness, fatigue, bilateral eye drainage, and a decrease in appetite and was admitted to the hospital for further workup. On admission, creatine kinase was 2080 IU/L with myoglobin of 7601 ng/mL. The patient's diagnosis was statin myopathy with possible rhabdomyolysis acute kidney injury. Likely contributing factors included cyclosporine, leflunomide, and rosuvastatin DDI and administration of high-dose methylprednisolone. PRACTICE IMPLICATIONS This case demonstrates the importance of pharmacist involvement throughout all phases of care in a kidney transplant recipient.
Collapse
|
5
|
Kulkarni S, Watts MM, Kostapanos M. Statins. BMJ 2024; 384:e072584. [PMID: 38267068 DOI: 10.1136/bmj-2022-072584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- Spoorthy Kulkarni
- Clinical Pharmacology Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Michaela M Watts
- Clinical Pharmacology Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Lipid clinic, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust
| | - Michalis Kostapanos
- Clinical Pharmacology Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Lipid clinic, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust
| |
Collapse
|
6
|
Schade DS, Duro T, Eaton RP. Optimal Prescribing of Statins to Reduce Cardiovascular Disease. Am J Med 2023; 136:1133-1135. [PMID: 37572739 DOI: 10.1016/j.amjmed.2023.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/14/2023]
Affiliation(s)
- David S Schade
- Department of Internal Medicine, Division of Endocrinology, University of New Mexico Health Sciences Center, Albuquerque.
| | - Teodor Duro
- Department of Internal Medicine, Division of Endocrinology, University of New Mexico Health Sciences Center, Albuquerque
| | - R Philip Eaton
- Department of Internal Medicine, Division of Endocrinology, University of New Mexico Health Sciences Center, Albuquerque
| |
Collapse
|
7
|
Gallo G, Sarzani R, Cicero AFG, Genovese S, Pirro M, Gallelli L, Faggiano A, Volpe M. An Expert Opinion on the Role of the Rosuvastatin/Amlodipine Single Pill Fixed Dose Combination in Cardiovascular Prevention. High Blood Press Cardiovasc Prev 2023; 30:83-91. [PMID: 37020154 PMCID: PMC10089988 DOI: 10.1007/s40292-023-00570-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Abstract
Current cardiovascular disease prevention strategies are based on the management of cardiovascular risk as a continuum, redefining the therapeutic goals for each individual based on the estimated global risk profile. Given the frequent clustering of the principal cardiovascular risk factors, such as hypertension, diabetes and dyslipidaemia, in the same individual, patients are required to take multiple drugs to achieve therapeutic targets. The adoption of single pill fixed dose combinations may contribute to achieve better control of blood pressure and cholesterol compared to the separate administration of the individual drugs, mostly due to better adherence related to therapeutic simplicities. This paper reports the outcomes of an Expert multidisciplinary Roundtable. In particular, the rational and potential clinical use of the single pill fixed dose combination "Rosuvastatin-Amlodipine" for the management of concomitant hypertension/hypercholesterolemia in different clinical fields are discussed. This Expert Opinion also illustrates the importance of an early and effective management of total cardiovascular risk, highlights the substantial benefits of combining blood pressure and lipid-lowering treatments in a single-pill fixed dose combination and attempts to identify and overcome the barriers to the implementation in clinical practice of the fixed dose combinations with dual targets. This Expert Panel identifies and proposes the categories of patients who may benefit the most from this fixed dose combination.
Collapse
Affiliation(s)
- Giovanna Gallo
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, 'Hypertension Excellence Centre' of the European Society of Hypertension, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, University 'Politecnica delle Marche', Ancona, Italy
| | - Arrigo Francesco Giuseppe Cicero
- Hypertension and Cardiovascular Risk Research Unit, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
- IRCCS AOU Policlinico di S. Orsola, Bologna, Italy
| | - Stefano Genovese
- Endocrine and Metabolic Diseases Unit IRCCS Centro Cardiologico Monzino, 20138, Milan, Italy
| | - Matteo Pirro
- Unit of Internal Medicine, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Luca Gallelli
- Department of Health Sciences, Campus "Salvatore Venuta", University of Catanzaro "Magna Græcia", 88100, Catanzaro, Italy
| | - Andrea Faggiano
- Cardiovascular Unit, Internal Medicine Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, University of Milan, Milan, Italy
| | - Massimo Volpe
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy.
- IRCCS San Raffaele Roma, Rome, Italy.
| |
Collapse
|
8
|
Malik S, Cohen PR. Rosuvastatin-Induced Dizziness and Pruritus: A Case Report and Summary of Statin-Associated Dizziness and Pruritus. Cureus 2022; 14:e29014. [PMID: 36237799 PMCID: PMC9550838 DOI: 10.7759/cureus.29014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 12/02/2022] Open
Abstract
Drug-associated adverse events can present with varying symptoms, such as dizziness and pruritus. A 48-year-old woman initiated rosuvastatin to treat her elevated triglycerides. She developed rosuvastatin-associated adverse events, which included dizziness and pruritus within two weeks after starting treatment. After stopping the medication, the dizziness immediately cleared; the pruritus diminished during the next two weeks and eventually resolved completely. Side effects associated with rosuvastatin are discussed. The possibility of a medication-related etiology should be entertained when an individual suddenly develops either dizziness or pruritus or both.
Collapse
|
9
|
Sun Q, Li L, Zhou Q. Effects of Ethanolic Extract of Schisandra sphenanthera on the Pharmacokinetics of Rosuvastatin in Rats. Drug Des Devel Ther 2022; 16:1473-1481. [PMID: 35607596 PMCID: PMC9123906 DOI: 10.2147/dddt.s364234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Wuzhi capsule (WZ) is a proprietary Chinese medicine prepared from the ethanolic extract of Schisandra sphenanthera that is commonly used to treat liver injury. Statins are widely used in patients with hyperlipidemia, coronary heart disease, metabolic syndrome, type 2 diabetes mellitus, and nonalcoholic fatty liver disease. Co-administration of statins with WZ is possible in clinical practice. WZ has obvious inhibitory effects on the bioavailability of atorvastatin and simvastatin; however, the drug–herb interactions between WZ and rosuvastatin have not been addressed. We explored the effects of WZ on the pharmacokinetics of rosuvastatin in Sprague-Dawley rats to promote a rational use of statins. Methods Eighteen male rats were randomly and evenly divided into three groups: control group (gavage feeding of rosuvastatin 10 mg·kg−1), single dose group (gavage feeding of a single dose of WZ 150 mg·kg−1 followed by rosuvastatin 10 mg·kg−1) and multiple doses group (gavage feeding of WZ 150 mg·kg−1 for 7 days followed by rosuvastatin 10 mg·kg−1 on the seventh day). Plasma samples were collected at different times before and after rosuvastatin administration. The other 18 female rats were tested the same way as the male rats. All samples were analyzed by a validated LC-MS/MS method, and the pharmacokinetic parameters were calculated using a non-compartmental model. Results In both male and female rats, there were no statistically significant differences in rosuvastatin pharmacokinetic parameters between the control group, the single dose group, and the multi-dose group. Conclusion Acute or long-term intake of WZ had no obvious effect on the pharmacokinetics of rosuvastatin, and therefore rosuvastatin could be used as an alternative to atorvastatin and simvastatin when WZ is clinically required in conjunction with statins. An appropriate pharmacodynamic study is needed to encourage the safe use of this combination.
Collapse
Affiliation(s)
- Qing Sun
- Department of Pharmacy, Zhejiang Hospital, Hangzhou, People’s Republic of China
| | - Li Li
- Department of Pharmacy, Zhejiang Hospital, Hangzhou, People’s Republic of China
- Li Li, Department of Pharmacy, Zhejiang Hospital, No. 12 Lingyin Road, Hangzhou, 310013, Zhejiang Province, People’s Republic of China, Email
| | - Quan Zhou
- Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
- Correspondence: Quan Zhou, Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road No. 88, Shangcheng District, Hangzhou, 310009, Zhejiang Province, People’s Republic of China, Tel +86 571 89713473, Email
| |
Collapse
|
10
|
Anderson JLC, van der Giet M, Gomes Neto AW, Bakker SJL, Tietge UJF. Statin use and incident cardiovascular events in renal transplant recipients. Eur J Clin Invest 2021; 51:e13594. [PMID: 34042174 PMCID: PMC8596424 DOI: 10.1111/eci.13594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND Statins achieve potent LDL lowering in the general population leading to a significant cardiovascular (CV) risk reduction. In renal transplant recipients (RTR) statins are included in treatment guidelines, however, conclusive evidence of improved cardiovascular outcomes has not been uniformly provided and concerns have been raised about simultaneous use of statins and the immunosuppressant cyclosporine. This study aimed to elucidate the effect of statins on a compound CV endpoint, comprised of ischaemic CV events and CV mortality in RTR, with subgroup analysis focussing on cyclosporine users. METHOD 622 included RTR (follow-up 5.4 years) were matched based on propensity scores and dichotomized by statin use. Survival analysis was conducted. RESULTS Cox regression showed that statin use was not significantly associated with the compound CV endpoint in a fully adjusted model (HR = 0.81, 95% CI = 0.53-1.24, P = .33). Subgroup analyses in RTR using cyclosporine revealed a strong positive association of statin use with the CV compound outcome in a fully adjusted model (HR = 6.60, 95% CI 1.75-24.9, P = .005). Furthermore, statin use was positively correlated with cyclosporine trough levels (correlation coefficient 0.11, P = .04). CONCLUSION In conclusion, statin use does not significantly decrease incident CV events in an overall RTR cohort, but is independently associated with CV-specific mortality and events in cyclosporine using RTR, possibly due to a bilateral pharmacological interaction.
Collapse
Affiliation(s)
- Josephine L C Anderson
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Markus van der Giet
- Medizinische Klinik für Nephrologie und Internistische Intensivtherapie, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Antonio W Gomes Neto
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Uwe J F Tietge
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Clinical Chemistry, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
11
|
Ning C, Su S, Li J, Kong D, Cai H, Qin Z, Xing H, Chen X, He J. Evaluation of a Clinically Relevant Drug-Drug Interaction Between Rosuvastatin and Clopidogrel and the Risk of Hepatotoxicity. Front Pharmacol 2021; 12:715577. [PMID: 34646133 PMCID: PMC8504577 DOI: 10.3389/fphar.2021.715577] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/06/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose: The combination therapy of rosuvastatin (RSV) and the platelet inhibitor clopidogrel (CP) is widely accepted in the management of cardiovascular diseases. The objective of the present study was to identify the mechanism of RSV–CP DDI and evaluate the risk of hepatotoxicity associated with the concomitant use of CP. Methods: We first studied the effect of CP and its major circulating metabolite, carboxylic acid metabolite (CPC), on RSV transport by overexpressing cells and membrane vesicles. Second, we investigated whether a rat model could replicate this DDI and then be used to conduct mechanistic studies and assess the risk of hepatotoxicity. Then, cytotoxicity assay in hepatocytes, biochemical examination, and histopathology were performed to measure the magnitude of liver injury in the presence and absence of DDI. Results: CP inhibited OATP1B1-mediated transport of RSV with an IC50 value of 27.39 μM. CP and CPC inhibited BCRP-mediated RSV transport with IC50 values of <0.001 and 5.96 μM, respectively. The CP cocktail (0.001 μM CP plus 2 μM CPC) significantly inhibited BCRP-mediated transport of RSV by 26.28%. Multiple p.o. doses of CP significantly increased intravenous RSV plasma AUC0-infinity by 76.29% and decreased intravenous RSV CL by 42.62%. Similarly, multiple p.o. doses of CP significantly increased p.o. RSV plasma AUC0-infinity by 87.48% and decreased p.o. RSV CL by 43.27%. CP had no effect on cell viability, while RSV exhibited dose-dependent cytotoxicity after 96 h incubation. Co-incubation of 100 μM CP and RSV for 96 h significantly increased intracellular concentrations and cell-to-medium concentration ratios of RSV and reduced hepatocyte viability. Histological evaluation of liver specimens showed patterns of drug-induced liver injury. Cholestasis was found in rats in the presence of DDI. Conclusion: CP is not a clinically relevant inhibitor for OATP1B1 and OATP1B3. The primary mechanism of RSV–CP DDI can be attributed to the inhibition of intestinal BCRP by CP combined with the inhibition of hepatic BCRP by CPC. The latter is likely to be more clinically relevant and be a contributing factor for increased hepatotoxicity in the presence of DDI.
Collapse
Affiliation(s)
- Chen Ning
- Department of Pharmacy, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Shengdi Su
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jiaming Li
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Dexuan Kong
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Hui Cai
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Zhiying Qin
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Han Xing
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Xijing Chen
- Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jiake He
- Department of Pharmacy, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Clinical Pharmacokinetics Laboratory, School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.,Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| |
Collapse
|
12
|
Sabanis N, Paschou E, Drylli A, Papanikolaou P, Zagkotsis G. Rosuvastatin and Colchicine combined myotoxicity: lessons to be learnt. CEN Case Rep 2021; 10:570-575. [PMID: 34028728 DOI: 10.1007/s13730-021-00598-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 03/23/2021] [Indexed: 10/21/2022] Open
Abstract
Statins and colchicine co-administration consists of a potentially catastrophic drug-drug interaction since it provokes myotoxicity, myopathy and various degrees of rhabdomyolysis. Lipophilic statins and colchicine are biotransformed in the liver, primarily via CYP3A4 enzyme system leading to elevated blood levels of both agents and resulting in increased potential for combined myotoxicity. Hence, it would be of great clinical importance not only the awareness of this devastating complication but also the more advantageous type of statin that we should choose to achieve the recommended therapeutic goals regarding LDL levels with minimal myopathy risk. Therefore, once colchicine's use is commenced, a hydrophilic statin selection, such as rosuvastatin, seems favorable regarding the risk of myotoxicity. Herein, we aim to describe a patient with chronic kidney disease stage III and nephrotic syndrome that developed acute rhabdomyolysis soon after the administration of rosuvastatin while receiving colchicine. To the best of our knowledge, this is the first report of the combined effect of rosuvastatin and colchicine in the setting of chronic kidney disease leading to myotoxicity.
Collapse
Affiliation(s)
- Nikolaos Sabanis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece.
| | - Eleni Paschou
- Medical Unit of St Georgios, Department of General Practice & Family Medicine, Livadeia, Greece
| | - Aikaterini Drylli
- Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | | | - Georgios Zagkotsis
- Department of Nephrology, General Hospital of Livadeia, Livadeia, Greece
| |
Collapse
|
13
|
Dulka K, Szabo M, Lajkó N, Belecz I, Hoyk Z, Gulya K. Epigenetic Consequences of in Utero Exposure to Rosuvastatin: Alteration of Histone Methylation Patterns in Newborn Rat Brains. Int J Mol Sci 2021; 22:ijms22073412. [PMID: 33810299 PMCID: PMC8059142 DOI: 10.3390/ijms22073412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 12/16/2022] Open
Abstract
Rosuvastatin (RST) is primarily used to treat high cholesterol levels. As it has potentially harmful but not well-documented effects on embryos, RST is contraindicated during pregnancy. To demonstrate whether RST could induce molecular epigenetic events in the brains of newborn rats, pregnant mothers were treated daily with oral RST from the 11th day of pregnancy for 10 days (or until delivery). On postnatal day 1, the brains of the control and RST-treated rats were removed for Western blot or immunohistochemical analyses. Several antibodies that recognize different methylation sites for H2A, H2B, H3, and H4 histones were quantified. Analyses of cell-type-specific markers in the newborn brains demonstrated that prenatal RST administration did not affect the composition and cell type ratios as compared to the controls. Prenatal RST administration did, however, induce a general, nonsignificant increase in H2AK118me1, H2BK5me1, H3, H3K9me3, H3K27me3, H3K36me2, H4, H4K20me2, and H4K20me3 levels, compared to the controls. Moreover, significant changes were detected in the number of H3K4me1 and H3K4me3 sites (134.3% ± 19.2% and 127.8% ± 8.5% of the controls, respectively), which are generally recognized as transcriptional activators. Fluorescent/confocal immunohistochemistry for cell-type-specific markers and histone methylation marks on tissue sections indicated that most of the increase at these sites belonged to neuronal cell nuclei. Thus, prenatal RST treatment induces epigenetic changes that could affect neuronal differentiation and development.
Collapse
Affiliation(s)
- Karolina Dulka
- Department of Cell Biology and Molecular Medicine, University of Szeged, 6720 Szeged, Hungary; (K.D.); (M.S.); (N.L.)
| | - Melinda Szabo
- Department of Cell Biology and Molecular Medicine, University of Szeged, 6720 Szeged, Hungary; (K.D.); (M.S.); (N.L.)
| | - Noémi Lajkó
- Department of Cell Biology and Molecular Medicine, University of Szeged, 6720 Szeged, Hungary; (K.D.); (M.S.); (N.L.)
| | - István Belecz
- Department of Medical Biology, University of Szeged, 6720 Szeged, Hungary;
| | - Zsófia Hoyk
- Biological Barriers Research Group, Institute of Biophysics, Biological Research Center, Eötvös Loránd Research Network, 6726 Szeged, Hungary;
| | - Karoly Gulya
- Department of Cell Biology and Molecular Medicine, University of Szeged, 6720 Szeged, Hungary; (K.D.); (M.S.); (N.L.)
- Correspondence:
| |
Collapse
|
14
|
Asad M, Asdaq SMB, Mohzari Y, Alrashed A, Alajami HN, Aljohani AO, Mushtawi AAA, Alajmi AN, Alajmi HN, Imran M, Orfali R. Pharmacokinetic and pharmacodynamic interaction of Rosuvastatin calcium with guggulipid extract in rats. Saudi J Biol Sci 2021; 28:3490-3496. [PMID: 34121889 PMCID: PMC8176130 DOI: 10.1016/j.sjbs.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 01/17/2023] Open
Abstract
Background & objectives Rosuvastatin calcium (RC) is a potent and competitive synthetic inhibitor of HMG-CoA reductase used for the treatment of dyslipidemia. Guggulipid obtained from Commiphora mukul is used in the treatment of a wide variety of diseases such as atherosclerosis, hypercholesterolemia, rheumatism, and obesity. The present study evaluates the pharmacokinetic and pharmacodynamic interactions between RC and the standardized guggulipid extract in rats. Materials and methods The guggulipid extract was standardized for the presence of guggulsterones. The pharmacokinetic interaction was determined after a single dose administration of RC alone or in combination with the guggulipid extract or after multiple-dose administration of RC alone or RC along with the guggulipid extract for 14 days. To determine the pharmacodynamic interaction, RC and guggulipid extract were administered to hyperlipidemic rats for 14 days. The level of significance was determined using unpaired student’s t-test, one way ANOVA, the post-ANOVA Tukey test. Results Standardization of guggulipid extract showed it contains 7.5%w/w of guggulsterones. Guggulipid extract increased the bioavailability of RC in both single-dose and multiple-dose studies. Guggulipid extract reduced the rate of absorption (Ka) of RC but showed an increase in maximum serum concentration (Cmax). An in-vitro study using isolated rat intestine revealed that guggulipid extract decreased the rate of absorption of RC in the intestinal lumen. The hypolipidemic activity of RC was augmented by the guggulipid extract in hyperlipidemic rats. Interpretation & conclusion Therefore it is concluded that guggulipid extract increases the bioavailability of RC by delaying its Ka and augments its hypolipidemic action. However, it is recommended that a combination of RC with guggulipid extract should be used only after an adverse effect(s) of this combination are determined.
Collapse
Affiliation(s)
- Mohammed Asad
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Shaqra University, Shaqra 11911, Saudi Arabia
| | | | - Yahya Mohzari
- Clinical Pharmacy Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmed Alrashed
- Pharmaceutical Services Administration, Inpatient Department, Main Hospital, KFMC, Riyadh 11564, Saudi Arabia
| | - Hamdan Najib Alajami
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Awad Othman Aljohani
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Ali Al Mushtawi
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Assil Najib Alajmi
- Pharmaceutical Services Administration, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Hanan Nageeb Alajmi
- Pharmaceutical Services Administration, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, P.O. BOX 840, Rafha 91911, Saudi Arabia
| | - Raha Orfali
- Department of Pharmacognosy, Collage of Pharmacy, King Saud university, P.O.Box 22452, Riyadh 11495, Saudi Arabia
| |
Collapse
|
15
|
Liu Q, Xu J, Liao K, Tang N. Oral Bioavailability Improvement of Tailored Rosuvastatin Loaded Niosomal Nanocarriers to Manage Ischemic Heart Disease: Optimization, Ex Vivo and In Vivo Studies. AAPS PharmSciTech 2021; 22:58. [PMID: 33502651 DOI: 10.1208/s12249-021-01934-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 01/13/2021] [Indexed: 12/19/2022] Open
Abstract
Rosuvastatin is an efficient antihyperlipidemic agent; however, being a BCS class II molecule, it shows poor oral bioavailability of < 20%. The present study focused on the improvement of oral bioavailability of rosuvastatin using tailored niosomes. The niosomes were prepared by film hydration method and sonication using cholesterol and Span 40. The Box-Behnken design (BBD) was applied to optimize the size (98 nm) and the entrapment efficacy (77%) of the niosomes by selecting cholesterol at 122 mg, Span 40 at 0.52%, and hydration time at 29.88 min. The transmission electron microscopy image showed spherical shape niosomes with smooth surface without aggregation. The ex vivo intestinal permeability studies showed significant improvement in the rosuvastatin permeation (95.5% after 2 h) using niosomes in comparison to the rosuvastatin suspension (40.1% after 2 h). The in vivo pharmacokinetic parameters in the rat model confirmed the improvement in the oral bioavailability with optimized rosuvastatin loaded niosomes (relative bioavailability = 2.01) in comparison to the rosuvastatin suspension, due to high surface area of niosomes and its lymphatic uptake via transcellular route. In conclusion, the optimized rosuvastatin loaded niosomes offers a promising approach to improve the oral bioavailability of rosuvastatin.
Collapse
|
16
|
Ahmadi M, Amiri S, Pecic S, Machaj F, Rosik J, Łos MJ, Alizadeh J, Mahdian R, da Silva Rosa SC, Schaafsma D, Shojaei S, Madrakian T, Zeki AA, Ghavami S. Pleiotropic effects of statins: A focus on cancer. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165968. [PMID: 32927022 DOI: 10.1016/j.bbadis.2020.165968] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/21/2020] [Accepted: 09/07/2020] [Indexed: 02/07/2023]
Abstract
The statin drugs ('statins') potently inhibit hydroxymethylglutaryl-coenzyme A (HMG-CoA) reductase by competitively blocking the active site of the enzyme. Statins decrease de novo cholesterol biosynthesis and thereby reduce plasma cholesterol levels. Statins exhibit "pleiotropic" properties that are independent of their lipid-lowering effects. For example, preclinical evidence suggests that statins inhibit tumor growth and induce apoptosis in specific cancer cell types. Furthermore, statins show chemo-sensitizing effects by impairing Ras family GTPase signaling. However, whether statins have clinically meaningful anti-cancer effects remains an area of active investigation. Both preclinical and clinical studies on the potential mechanisms of action of statins in several cancers have been reviewed in the literature. Considering the contradictory data on their efficacy, we present an up-to-date summary of the pleiotropic effects of statins in cancer therapy and review their impact on different malignancies. We also discuss the synergistic anti-cancer effects of statins when combined with other more conventional anti-cancer drugs to highlight areas of potential therapeutic development.
Collapse
Affiliation(s)
- Mazaher Ahmadi
- Department of Analytical Chemistry, Faculty of Chemistry, Bu-Ali Sina University, Hamedan, Iran
| | - Shayan Amiri
- Division of Neurodegenerative Disorders, St Boniface Hospital Albrechtsen Research Centre, R4046 - 351 Taché Ave, Winnipeg, Manitoba R2H 2A6, Canada; Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, Canada
| | - Stevan Pecic
- Department of Chemistry and Biochemistry, California State University Fullerton, CA, USA
| | - Filip Machaj
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Department of Pathology, Pomeranian Medical University in Szczecin, Poland
| | - Jakub Rosik
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Department of Pathology, Pomeranian Medical University in Szczecin, Poland
| | - Marek J Łos
- Biotechnology Center, Silesian University of Technology, Gliwice, Poland
| | - Javad Alizadeh
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Biology of Breathing Theme, Children Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Canada
| | - Reza Mahdian
- Molecular Medicine Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Simone C da Silva Rosa
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | | | - Shahla Shojaei
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tayyebeh Madrakian
- Department of Analytical Chemistry, Faculty of Chemistry, Bu-Ali Sina University, Hamedan, Iran
| | - Amir A Zeki
- University of California, Davis School of Medicine. Division of Pulmonary, Critical Care, and Sleep Medicine. U.C. Davis Lung Center, Davis, California, USA; Veterans Affairs Medical Center, Mather, California, USA
| | - Saeid Ghavami
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran; Research Institute of Oncology and Hematology, Cancer Care Manitoba, University of Manitoba, Winnipeg, Canada.
| |
Collapse
|
17
|
Wlosinska M, Nilsson AC, Hlebowicz J, Hauggaard A, Kjellin M, Fakhro M, Lindstedt S. The effect of aged garlic extract on the atherosclerotic process - a randomized double-blind placebo-controlled trial. BMC Complement Med Ther 2020; 20:132. [PMID: 32349742 PMCID: PMC7191741 DOI: 10.1186/s12906-020-02932-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 04/22/2020] [Indexed: 02/08/2023] Open
Abstract
Background One of the most serious secondary manifestations of Cardiovascular Disease (CVD) is coronary atherosclerosis. This study aimed to evaluate whether aged garlic extract (AGE) can influence coronary artery calcification (CAC) and to predict the individual effect of AGE using a standard process for data mining (CRISP–DM). Method This was a single-center parallel randomized controlled study in a university hospital in Europe. Patients were randomized, in a double-blind manner, through a computer-generated randomization chart. Patients with a Framingham risk score ≥ 10 after CT scan (n = 104) were randomized to an intake of placebo or AGE (2400 mg daily) for 1 year. Main outcome measures were changes in CAC score and secondary outcome measures changes in blood pressure, fasting blood glucose, blood lipids and inflammatory biomarkers. Result 104 patients were randomized and 46 in the active group and 47 in the placebo group were analyzed. There was a significant (p < 0.05) change in CAC progression (OR: 2.95 [1.05–8.27]), blood glucose (OR: 3.1 [1.09–8.85]) and IL-6 (OR 2.56 [1.00–6.53]) in favor of the active group. There was also a significant (p = 0.027) decrease in systolic blood pressure in the AGE group, from a mean of 148 (SD: 19) mmHg at 0 months, to 140 (SD: 15) mmHg after 12 months. The AGE Algorithm, at a selected probability cut-off value of 0.5, the accuracy score for CAC progression was 80%, precision score of 79% and recall score 83%. The score for blood pressure was 74% (accuracy, precision and recall). There were no side-effects in either group. Conclusions AGE inhibits CAC progression, lowers IL–6, glucose levels and blood pressure in patients at increased risk of cardiovascular events in a European cohort. An algorithm was made and was used to predict with 80% precision which patient will have a significantly reduced CAC progression using AGE. The algorithm could also predict with a 74% precision which patient will have a significant blood pressure lowering effect pressure using AGE. Trial registration Clinical trials NCT03860350, retrospectively registered (1/32019).
Collapse
Affiliation(s)
- Martiné Wlosinska
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Ann-Christin Nilsson
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Joanna Hlebowicz
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Hauggaard
- Department of Radiology, Cardiac Imaging, Skåne Hospital Northwest, Helsingborg, Sweden
| | - Maria Kjellin
- Department of Radiology, Cardiac Imaging, Skåne Hospital Northwest, Helsingborg, Sweden
| | - Mohammed Fakhro
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden
| | - Sandra Lindstedt
- Department of Cardiothoracic Surgery and Transplantation, Clinical Sciences, Lund University, Skåne University Hospital, SE-221 85, Lund, Sweden.
| |
Collapse
|
18
|
Strilchuk L, Tocci G, Fogacci F, Cicero AFG. An overview of rosuvastatin/ezetimibe association for the treatment of hypercholesterolemia and mixed dyslipidemia. Expert Opin Pharmacother 2020; 21:531-539. [DOI: 10.1080/14656566.2020.1714028] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Larysa Strilchuk
- Department of Therapy and Medical Diagnostics, Lviv National Medical University, Lviv, Ukraine
| | - Giuliano Tocci
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, University of Rome Sapienza, Sant’Andrea Hospital, Rome, Italy
- Cardiology Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Federica Fogacci
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Arrigo F. G. Cicero
- Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| |
Collapse
|
19
|
El-Wekil MM, Abdelhady KK, Abdel Salam RA, Hadad GM, Ali R. Facile synthesis of novel nanocomposite prepared from spinel copper ferrite and reduced graphene oxide in the presence of anti-fouling agent diethyl ammonium acid sulphate for ultrasensitive detection of rosuvastatin in human plasma. Microchem J 2019. [DOI: 10.1016/j.microc.2019.04.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
20
|
Bai X, Zhang B, Wang P, Wang GL, Li JL, Wen DS, Long XZ, Sun HS, Liu YB, Huang M, Zhong SL. Effects of SLCO1B1 and GATM gene variants on rosuvastatin-induced myopathy are unrelated to high plasma exposure of rosuvastatin and its metabolites. Acta Pharmacol Sin 2019; 40:492-499. [PMID: 29950617 DOI: 10.1038/s41401-018-0013-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/24/2018] [Accepted: 01/25/2018] [Indexed: 12/29/2022] Open
Abstract
Myotoxicity is a significant factor contributing to the poor adherence and reduced effectiveness in the treatment of statins. Genetic variations and high drug plasma exposure are considered as critique causes for statin-induced myopathy (SIM). This study aims to explore the sequential influences of rosuvastatin (RST) pharmacokinetic and myopathy-related single-nucleotide polymorphisms (SNPs) on the plasma exposure to RST and its metabolites: rosuvastatin lactone (RSTL) and N-desmethyl rosuvastatin (DM-RST), and further on RST-induced myopathy. A total of 758 Chinese patients with coronary artery disease were enrolled and followed up SIM incidents for 2 years. The plasma concentrations of RST and its metabolites were determined through a validated ultra-performance liquid chromatography mass spectrometry method. Nine SNPs in six genes were genotyped by using the Sequenom MassArray iPlex platform. Results revealed that ABCG2 rs2231142 variations were highly associated with the plasma concentrations of RST, RSTL, and DM-RST (Padj < 0.01, FDR < 0.05). CYP2C9 rs1057910 significantly affected the DM-RST concentration (Padj < 0.01, FDR < 0.05). SLCO1B1 rs4149056 variant allele was significantly associated with high SIM risk (OR: 1.741, 95% CI: 1.180-2.568, P = 0.0052, FDR = 0.0468). Glycine amidinotransferase (GATM) rs9806699 was marginally associated with SIM incidents (OR: 0.617, 95% CI: 0.406-0.939, P = 0.0240, FDR = 0.0960). The plasma concentrations of RST and its metabolites were not significantly different between the SIM (n = 51) and control groups (n = 707) (all P > 0.05). In conclusion, SLCO1B1 and GATM genetic variants are potential biomarkers for predicting RST-induced myopathy, and their effects on SIM are unrelated to the high plasma exposure of RST and its metabolites.
Collapse
|
21
|
Moussa BA, Hashem HM, Mahrouse MA, Mahmoud ST. A validated RP-HPLC method for the determination of rosuvastatin in presence of sacubitril/valsartan in rat plasma: Application to in vivo evaluation of OATP-mediated drug interaction potential between rosuvastatin and sacubitril/valsartan. Microchem J 2018. [DOI: 10.1016/j.microc.2018.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
22
|
Ahmadi Y, Karimian R, Panahi Y. Effects of statins on the chemoresistance-The antagonistic drug-drug interactions versus the anti-cancer effects. Biomed Pharmacother 2018; 108:1856-1865. [PMID: 30372891 DOI: 10.1016/j.biopha.2018.09.122] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 09/16/2018] [Accepted: 09/19/2018] [Indexed: 12/31/2022] Open
Abstract
There has been growing interest in the potential anti-cancer activity of statins based on evidence of their anti-proliferative, pro-apoptotic, and radiosensitizing properties, but no studies have focused on the effects of statins on the chemoresistance. In spite of their direct cytostatic/cytotoxic effects on the cancer cells, statins via drug interactions may affect therapeutic effects of the chemotherapy agents and so cause chemoresistance in cancer cells. Here, we aim to present the molecular mechanisms underlying cytotoxic effects of statins on the cancer cells against those mechanisms by which statins may lead to chemoresistance, in order to clarify whether the positive effects of the co-treatment of statins on the efficiency of chemotherapeutic agents is due to the natural anti-cancer effects of statins or it is due to increasing the cellular concentrations of chemotherapy drugs in cancer cells.
Collapse
Affiliation(s)
- Yasin Ahmadi
- Chemical Injuries Research Center, Systems biology and poisonings institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Ramin Karimian
- Chemical Injuries Research Center, Systems biology and poisonings institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Yunes Panahi
- Chemical Injuries Research Center, Systems biology and poisonings institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| |
Collapse
|
23
|
Kim CH, An H, Kim SH, Shin D. Pharmacokinetic and pharmacodynamic interaction between ezetimibe and rosuvastatin in healthy male subjects. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:3461-3469. [PMID: 29255347 PMCID: PMC5723108 DOI: 10.2147/dddt.s146863] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background and objective Rosuvastatin and ezetimibe are commonly applied in lipid-lowering pharmacotherapy. However, the pharmacokinetic (PK) interaction was not clear by the coadministration of rosuvastatin and ezetimibe. This study investigated the pharmacodynamic (PD) and PK interactions between rosuvastatin and ezetimibe through a crossover clinical trial. Subjects and methods A randomized, open-label, multiple-dose, two-treatment, two-period, two-sequence crossover study with two treatment parts was conducted in healthy male subjects. Study part A involved rosuvastatin, and study part B involved ezetimibe. A total of 25 subjects in both parts completed the PK and PD evaluations. Rosuvastatin (20 mg) or ezetimibe (10 mg) was administered once daily for 7 days as monotherapy or co-therapy. The plasma concentrations of rosuvastatin, total ezetimibe and free ezetimibe were measured for 72 h after day 7. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) were investigated for the PD assessments on day 1 (pretreatment) and day 8. Results Rosuvastatin and ezetimibe presented multiple peaks. The 90% confidence intervals (CIs) of the geometric mean ratios for the peak plasma concentration at steady state (Cmax,ss) and area under the plasma concentration-time curve during the dosing interval at steady state (AUCτ,ss) of rosuvastatin and total ezetimibe were within the range 0.8-1.25. However, the coadministration increased the systemic exposure of free ezetimibe. In the PD assessments, rosuvastatin and ezetimibe monotherapy reduced the LDL-C and TC levels effectively. In addition, the lipid-lowering effects of the coadministration corresponded to an approximate summation of the effects of rosuvastatin and ezetimibe monotherapy. However, no significant changes in HDL-C were observed with rosuvastatin or ezetimibe treatment. No significant safety issue was noted. Conclusion The coadministration of rosuvastatin and ezetimibe revealed a bioequivalent PK interaction. Additional lipid-lowering effects, including decreased LDL-C and TC, were observed as expected in combination therapy without significant safety concern.
Collapse
Affiliation(s)
- Chang Hee Kim
- Department of Urology, Gachon University Gil Medical Center, Incheon
| | - Hyungmi An
- Department of Statistics, Seoul National University, Seoul
| | - Sung Hye Kim
- Clinical Development, Navipharm Co., Ltd., Suwon
| | - Dongseong Shin
- Clinical Trials Center, Gachon University Gil Medical Center, Incheon, South Korea
| |
Collapse
|
24
|
Min KL, Park MS, Jung J, Chang MJ, Kim CO. Comparison of Pharmacokinetics and Safety of a Fixed-dose Combination of Rosuvastatin and Ezetimibe Versus Separate Tablets in Healthy Subjects. Clin Ther 2017; 39:1799-1810. [DOI: 10.1016/j.clinthera.2017.07.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 11/24/2022]
|
25
|
Galyfos G, Sianou A, Filis K. Pleiotropic effects of statins in the perioperative setting. Ann Card Anaesth 2017; 20:S43-S48. [PMID: 28074822 PMCID: PMC5299828 DOI: 10.4103/0971-9784.197796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Statins belong to a specific group of drugs that have been described for their ability to control hyperlipidemia as well as for other pleiotropic effects such as improving vascular endothelial function, inhibition of oxidative stress pathways, and anti-inflammatory actions. Accumulating clinical evidence strongly suggests that statins also have a beneficial effect on perioperative morbidity and mortality. Therefore, this review aims to present all recent and pooled data on statin treatment in the perioperative setting as well as to highlight considerations regarding their indications and therapeutic application.
Collapse
Affiliation(s)
- George Galyfos
- Department of Propaedeutic Surgery, Division of Vascular Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| | - Argyri Sianou
- Department of Microbiology, University of Athens Medical School, Areteion Hospital, Athens, Greece
| | - Konstantinos Filis
- Department of Propaedeutic Surgery, Division of Vascular Surgery, University of Athens Medical School, Hippocration Hospital, Athens, Greece
| |
Collapse
|
26
|
Barkas F, Elisaf M, Klouras E, Dimitriou T, Tentolouris N, Liberopoulos E. Statin escape phenomenon: Fact or fiction? World J Exp Med 2017; 7:25-30. [PMID: 28261552 PMCID: PMC5316901 DOI: 10.5493/wjem.v7.i1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/10/2016] [Accepted: 01/02/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the presence of the so called "statin escape" phenomenon among hyperlipidemic subjects attending a lipid clinic. METHODS This was a retrospective analysis of 1240 hyperlipidemic individuals followed-up for ≥ 3 years. We excluded those individuals meeting one of the following criteria: Use of statin therapy at baseline visit, discontinuation of statin treatment at most recent visit, change in statin treatment during follow-up and poor compliance to treatment. Statin escape phenomenon was defined as an increase in low-density lipoprotein cholesterol (LDL-C) levels at the most recent visit by > 10% compared with the value at 6 mo following initiation of statin treatment. RESULTS Of 181 eligible subjects, 31% exhibited the statin escape phenomenon. No major differences regarding baseline characteristics were found between statin escapers and non-statin escapers. Both escapers and non-escapers had similar baseline LDL-C levels [174 (152-189) and 177 (152-205) mg/dL, respectively]. In comparison with non-escapers, statin escapers demonstrated lower LDL-C levels at 6 mo after treatment initiation [88 (78-97) mg/dL vs 109 (91-129) mg/dL, P < 0.05], but higher levels at the most recent visit [103 (96-118) mg/dL vs 94 (79-114) mg/dL, P < 0.05]. CONCLUSION These data confirm the existence of an escape phenomenon among statin-treated individuals. The clinical significance of this phenomenon remains uncertain.
Collapse
|
27
|
El-Ganainy SO, El-Mallah A, Abdallah D, Khattab MM, Mohy El-Din MM, El-Khatib AS. Rosuvastatin safety: An experimental study of myotoxic effects and mitochondrial alterations in rats. Toxicol Lett 2016; 265:23-29. [PMID: 27815113 DOI: 10.1016/j.toxlet.2016.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 10/28/2016] [Accepted: 10/31/2016] [Indexed: 01/14/2023]
Abstract
Myopathy is the most commonly reported adverse effect of statins. All statins are associated with myopathy, though with different rates. Rosuvastatin is a potent statin reported to induce myopathy comparable to earlier statins. However, in clinical practice most patients could tolerate rosuvastatin over other statins. This study aimed to evaluate the myopathic pattern of rosuvastatin in rats using biochemical, functional and histopathological examinations. The possible deleterious effects of rosuvastatin on muscle mitochondria were also examined. The obtained results were compared to myopathy induced by atorvastatin in equimolar dose. Results showed that rosuvastatin induced a rise in CK, a slight increase in myoglobin level together with mild muscle necrosis. Motor activity, assessed by rotarod, showed that rosuvastatin decreased rats' performance. All these manifestations were obviously mild compared to the prominent effects of atorvastatin. Parallel results were obtained in mitochondrial dysfunction parameters. Rosuvastatin only induced a slight increase in LDH and a minor decrease in ATP (∼14%) and pAkt (∼12%). On the other hand, atorvastatin induced an increase in LDH, lactate/pyruvate ratio and a pronounced decline in ATP (∼80%) and pAkt (∼65%). These findings showed that rosuvastatin was associated with mild myotoxic effects in rats, especially when compared to atorvastatin.
Collapse
Affiliation(s)
- Samar O El-Ganainy
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharos University, Alexandria, Egypt.
| | - Ahmed El-Mallah
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharos University, Alexandria, Egypt
| | - Dina Abdallah
- Department of Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mahmoud M Khattab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Mahmoud M Mohy El-Din
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Pharos University, Alexandria, Egypt
| | - Aiman S El-Khatib
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| |
Collapse
|
28
|
Backes J, Anzalone D, Hilleman D, Catini J. The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia. Lipids Health Dis 2016; 15:118. [PMID: 27444154 PMCID: PMC4957330 DOI: 10.1186/s12944-016-0286-4] [Citation(s) in RCA: 111] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 07/08/2016] [Indexed: 12/19/2022] Open
Abstract
Hypertriglyceridemia (triglycerides > 150 mg/dL) affects ~25 % of the United States (US) population and is associated with increased cardiovascular risk. Severe hypertriglyceridemia (≥ 500 mg/dL) is also a risk factor for pancreatitis. Three omega-3 fatty acid (OM3FA) prescription formulations are approved in the US for the treatment of adults with severe hypertriglyceridemia: (1) OM3FA ethyl esters (OM3EE), a mixture of OM3FA ethyl esters, primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) (Lovaza®, Omtryg™, and generics); (2) icosapent ethyl (IPE), EPA ethyl esters (Vascepa®); and (3) omega-3 carboxylic acids (OM3CA), a mixture of OM3FAs in free fatty acid form, primarily EPA, DHA, and docosapentaenoic acid (Epanova®). At approved doses, all formulations substantially reduce triglyceride and very-low-density lipoprotein levels. DHA-containing formulations may also increase low-density lipoprotein cholesterol. However, this is not accompanied by increased non-high-density lipoprotein cholesterol, which is thought to provide a better indication of cardiovascular risk in this patient population. Proposed mechanisms of action of OM3FAs include inhibition of diacylglycerol acyltransferase, increased plasma lipoprotein lipase activity, decreased hepatic lipogenesis, and increased hepatic β-oxidation. OM3CA bioavailability (area under the plasma concentration-time curve from zero to the last measurable concentration) is up to 4-fold greater than that of OM3FA ethyl esters, and unlike ethyl esters, the absorption of OM3CA is not dependent on pancreatic lipase hydrolysis. All three formulations are well tolerated (the most common adverse events are gastrointestinal) and demonstrate a lack of drug-drug interactions with other lipid-lowering drugs, such as statins and fibrates. OM3FAs appear to be an effective treatment option for patients with severe hypertriglyceridemia.
Collapse
Affiliation(s)
- James Backes
- Atherosclerosis and LDL-Apheresis Center, School of Pharmacy, University of Kansas, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA.
| | | | | | | |
Collapse
|
29
|
Abstract. Drug Metab Rev 2016. [DOI: 10.1080/03602532.2016.1191843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
30
|
Garg M, Khanna D, Kalra S, Balakumar P. Chronic oral administration of low-dose combination of fenofibrate and rosuvastatin protects the rat heart against experimentally induced acute myocardial infarction. Fundam Clin Pharmacol 2016; 30:394-405. [DOI: 10.1111/fcp.12204] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Revised: 03/26/2016] [Accepted: 04/26/2016] [Indexed: 12/25/2022]
Affiliation(s)
- Monika Garg
- Cardiovascular Pharmacology Division; Department of Pharmacology; Rajendra Institute of Technology and Sciences; Sirsa 125 055 Haryana India
| | - Deepa Khanna
- Cardiovascular Pharmacology Division; Department of Pharmacology; Rajendra Institute of Technology and Sciences; Sirsa 125 055 Haryana India
| | - Sanjeev Kalra
- Cardiovascular Pharmacology Division; Department of Pharmacology; Rajendra Institute of Technology and Sciences; Sirsa 125 055 Haryana India
| | - Pitchai Balakumar
- Pharmacology Unit; Faculty of Pharmacy; AIMST University; Semeling 08100 Bedong Kedah DarulAman Malaysia
| |
Collapse
|
31
|
Abstract
Approximately 25% of US adults are estimated to have hypertriglyceridemia (triglyceride [TG] level ≥150 mg/dL [≥1.7 mmol/L]). Elevated TG levels are associated with increased cardiovascular disease (CVD) risk, and severe hypertriglyceridemia (TG levels ≥500 mg/dL [≥5.6 mmol/L]) is a well-established risk factor for acute pancreatitis. Plasma TG levels correspond to the sum of the TG content in TG-rich lipoproteins (TRLs; ie, very low-density lipoproteins plus chylomicrons) and their remnants. There remains some uncertainty regarding the direct causal role of TRLs in the progression of atherosclerosis and CVD, with cardiovascular outcome studies of TG-lowering agents, to date, having produced inconsistent results. Although low-density lipoprotein cholesterol (LDL-C) remains the primary treatment target to reduce CVD risk, a number of large-scale epidemiological studies have shown that elevated TG levels are independently associated with increased incidence of cardiovascular events, even in patients treated effectively with statins. Genetic studies have further clarified the causal association between TRLs and CVD. Variants in several key genes involved in TRL metabolism are strongly associated with CVD risk, with the strength of a variant's effect on TG levels correlating with the magnitude of the variant's effect on CVD. TRLs are thought to contribute to the progression of atherosclerosis and CVD via a number of direct and indirect mechanisms. They directly contribute to intimal cholesterol deposition and are also involved in the activation and enhancement of several proinflammatory, proapoptotic, and procoagulant pathways. Evidence suggests that non-high-density lipoprotein cholesterol, the sum of the total cholesterol carried by atherogenic lipoproteins (including LDL, TRL, and TRL remnants), provides a better indication of CVD risk than LDL-C, particularly in patients with hypertriglyceridemia. This article aims to provide an overview of the available epidemiological, clinical, and genetic evidence relating to the atherogenicity of TRLs and their role in the progression of CVD.
Collapse
Affiliation(s)
- Peter P Toth
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
| |
Collapse
|
32
|
Rosuvastatin: Beyond the cholesterol-lowering effect. Pharmacol Res 2016; 107:1-18. [PMID: 26930419 DOI: 10.1016/j.phrs.2016.02.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 02/13/2016] [Accepted: 02/14/2016] [Indexed: 12/18/2022]
|
33
|
Khan MW, Kurian S, Bishnoi R. Acute-onset rhabdomyolysis secondary to sitagliptin and atorvastatin interaction. Int J Gen Med 2016; 9:103-6. [PMID: 27199569 PMCID: PMC4857828 DOI: 10.2147/ijgm.s98543] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Rhabdomyolysis is a serious medical condition in which the skeletal muscle tissue gets damaged and breaks down at rapid rates, potentially leading to death if not managed early on. Rhabdomyolysis in adults has several etiologies such as crush injuries, prolonged immobilization, strenuous exercise, hormonal or metabolic causes, infections, and drug–drug interactions. We present a case report of the interaction of two drugs that are used commonly in the general population. We here discuss a case of a 60-year-old female who presented to the hospital with complaints of generalized weakness, muscle aches, and atypical chest pain for a week after her primary care physician started her on sitagliptin while she was already on atorvastatin. After review of literature, this is the second known case of such an interaction causing acute breakdown of skeletal musculature.
Collapse
Affiliation(s)
- Muhammad Waqas Khan
- Division of Hospital Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Saji Kurian
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Rohit Bishnoi
- Division of Hospital Medicine, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
34
|
|
35
|
Ito MK. Long-chain omega-3 fatty acids, fibrates and niacin as therapeutic options in the treatment of hypertriglyceridemia: A review of the literature. Atherosclerosis 2015; 242:647-56. [DOI: 10.1016/j.atherosclerosis.2015.06.012] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/03/2015] [Accepted: 06/08/2015] [Indexed: 12/19/2022]
|
36
|
|
37
|
DiNicolantonio JJ, Lavie CJ, Serebruany VL, O'Keefe JH. Statin Wars: The Heavyweight Match-Atorvastatin versus Rosuvastatin for the Treatment of Atherosclerosis, Heart Failure, and Chronic Kidney Disease. Postgrad Med 2015; 125:7-16. [DOI: 10.3810/pgm.2013.01.2620] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
38
|
Translational insight into statin-induced muscle toxicity: from cell culture to clinical studies. Transl Res 2014; 164:85-109. [PMID: 24530275 DOI: 10.1016/j.trsl.2014.01.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 01/15/2014] [Accepted: 01/17/2014] [Indexed: 02/06/2023]
Abstract
Statins are lipid-lowering drugs used widely to prevent and treat cardiovascular and coronary heart diseases. These drugs are among the most commonly prescribed medicines intended for long-term use. In general, statins are well tolerated. However, muscular adverse effects appear to be the most common obstacle that limits their use, resulting in poor patient compliance or even drug discontinuation. In addition, rare but potentially fatal cases of rhabdomyolysis have been reported with the use of these drugs, especially in the presence of certain risk factors. Previous reports have investigated statin-induced myotoxicity in vivo and in vitro using a number of cell lines, muscle tissues, and laboratory animals, in addition to randomized clinical trials, observational studies, and case reports. None of them have compared directly results from laboratory investigations with clinical observations of statin-related muscular adverse effects. To the best of our knowledge this is the first review article that combines laboratory investigation with clinical aspects of statin-induced myotoxicity. By reviewing published literature of in vivo, in vitro, and clinically relevant studies of statin myotoxicity, we aim to translate this important drug-related problem to establish a clear picture of proposed mechanisms that explain the risk factors and describe the diagnostic approaches currently used for evaluating the degree of muscle damage induced by these agents. This review provides baseline novel translational insight that can be used to enhance the safety profile, to minimize the chance of progression of these adverse effects to more severe and potentially fatal rhabdomyolysis, and to improve the overall patient compliance and adherence to long-term statin therapy.
Collapse
|
39
|
Abstract
The antitumour effect of statins has already been proven in animal experiments and human cancer cell lines in several gastrointestinal cancers. The chemopreventive mechanism is not completely clarified but the enhancement of oxidative stress, increased autophagy, altered expression of pro- and antiproliferative proteins and their influence on intracellular signaling pathways may play a role. Randomized studies, however, failed to confirme the expected results obtained from experimental studies. The goal of this review is to summarize the data available in the literature regarding the chemopreventive effects of statins on several gastrointestinal cancers. Results of clinical trials suggest that 10-20 mg statin daily has no or minimal antitumour effect. Chemopreventive effect of hydrophilic statins could not be detected but it seems to be significant in the case of hydrophobic statins. There are only few data available on the long-term daily use of 30-40 mg statins. Further long-term evaluation of the effect of statins regarding gastrointestinal cancers is needed, and an analysis of compound- and dose-related subgroups would be beneficial. Chemoprevention with statins cannot yet be accepted as standard medical practice. Use of statins as chemopreventive agents cannot be a substitute for regular oncological screening or surveillance.
Collapse
Affiliation(s)
- Veronika Sági
- Zala Megyei Kórház Belgyógyászati Osztály Zalaegerszeg Zrínyi M. u. 1. 8900
| | - László Herszényi
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest
| | - Zsolt Tulassay
- Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest
| | - Beáta Gasztonyi
- Zala Megyei Kórház Belgyógyászati Osztály Zalaegerszeg Zrínyi M. u. 1. 8900
| |
Collapse
|
40
|
Kostapanos MS, Rizos CV, Elisaf MS. Benefit–Risk Assessment of Rosuvastatin in the Treatment of Atherosclerosis and Related Diseases. Drug Saf 2014; 37:481-500. [PMID: 24788803 DOI: 10.1007/s40264-014-0169-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Michael S Kostapanos
- Department of Internal Medicine, Medical School, University of Ioannina, St. Niarchou Avenue, 45110, Ioannina, Greece
| | | | | |
Collapse
|
41
|
Gonen KA, Erfan G, Oznur M, Erdogan C. The first case of Henoch-Schonlein purpura associated with rosuvastatin: colonic involvement coexisting with small intestine. BMJ Case Rep 2014; 2014:bcr-2013-202644. [PMID: 24648473 DOI: 10.1136/bcr-2013-202644] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Henoch-Schönlein purpura (HSP) is a systemic vasculitis affecting small vessels. It is the most common systemic vasculitis in children, and is rare in adults. Serious gastrointestinal complications are more common in childhood. Infections and drugs are the most prominent factors in the aetiology. Wall thickening in segments of the small intestine is commonly seen in imaging studies in gastrointestinal system (GIS) involvement. Simultaneous involvement of small intestine and colon is rare. An HSP case involving small intestine and colon in an adult patient due to the use of rosuvastatin, an antihyperlipidaemic agent, is presented, and is first of its kind reported in the literature.
Collapse
Affiliation(s)
- Korcan Aysun Gonen
- Department of Radiology, School of Medicine, Namik Kemal University, Tekirdag, Turkey
| | | | | | | |
Collapse
|
42
|
Nicholls SJ, Uno K, Kataoka Y. Clinical experience with rosuvastatin in the management of hyperlipidemia and the reduction of cardiovascular risk. Expert Rev Cardiovasc Ther 2014; 9:1383-90. [DOI: 10.1586/erc.11.145] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
43
|
Ganesh JS, Rao YY, Ravikumar R, Jayakrishnan GA, Iwasaki M, Preethy S, Abraham SJK. Beneficial effects of black yeast derived 1-3, 1-6 Beta Glucan-Nichi Glucan in a dyslipidemic individual of Indian origin--a case report. J Diet Suppl 2014; 11:1-6. [PMID: 24409973 DOI: 10.3109/19390211.2013.859211] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Dyslipidemia is a major risk factor for the development of cardiovascular diseases and statins are the common drugs used to correct dyslipidemia. Herein, we report a case where the subject was a nondiabetic, dyslipidemia patient on medication with Rosuvastatin. After the intake of Rosuvastatin, his triglycerides decreased to a minimum of 220 mg/dL. In order to augment the action of Rosuvastatin, he was advised to take 1.5 mg of Nichi Glucan food supplement, which is a 1,3-1,6 Beta Glucan derived from the black yeast, Aureobasidium pullulans, daily for 2 months. At the end of 2 months, his triglyceride levels decreased from 523 mg/dL (at start of the study) to 175 mg/dL. His VLDL levels, which were 104.6 mg/dL at the start of the study decreased to 35 mg/dL and the HDL cholesterol levels increased from 27 to 38 mg/dL. This is a first of its kind report on the effect of the black yeast derived 1,3-1,6 Beta Glucans on dyslipidemia not associated with diabetes. Thus supplementation of Nichi Glucan, 1,3- 1,6 Beta Glucan derived from the black yeast along with the routine medications was beneficial to treat dyslipidemia and a larger trial is needed to confirm the effects.
Collapse
Affiliation(s)
- Jegatheesan Saravana Ganesh
- 1The Mary-Yoshio Translational Hexagon (MYTH), Nichi-In Centre for Regenerative Medicine (NCRM), Nungambakkam, Chennai 600034, India
| | | | | | | | | | | | | |
Collapse
|
44
|
Hu M, Tomlinson B. Evaluation of the pharmacokinetics and drug interactions of the two recently developed statins, rosuvastatin and pitavastatin. Expert Opin Drug Metab Toxicol 2013; 10:51-65. [PMID: 24156555 DOI: 10.1517/17425255.2014.851667] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Statins are the cornerstone of lipid-lowering therapy to reduce the risk of coronary heart disease. Rosuvastatin and pitavastatin are the two recently developed statins with less potential for drug interaction resulting in improved safety profiles. AREAS COVERED This review summarizes the pharmacokinetics and drug interactions of rosuvastatin and pitavastatin. The materials reviewed were identified by searching PubMed for publications using 'rosuvastatin', 'pitavastatin', 'statins', 'pharmacokinetics' and 'drug interaction' as the search terms. EXPERT OPINION Rosuvastatin and pitavastatin have favorable pharmacokinetic and safety profiles as their disposition does not depend on or is only marginally influenced by cytochrome P450 (CYP) enzymes, thus potentially reducing the risk of drug-drug interactions of these two statins with other drugs known to inhibit CYP enzymes. However, drug transporters play a significant role in the disposition of rosuvastatin and pitavastatin and drug interactions may occur through these. Genetic polymorphisms in drug transporters may also affect the pharmacokinetics, drug interactions and/or the lipid-lowering effect of these statins to a different extent.
Collapse
Affiliation(s)
- Miao Hu
- The Chinese University of Hong Kong, Department of Medicine & Therapeutics , Shatin , Hong Kong SAR
| | | |
Collapse
|
45
|
Dodiya H, Kale V, Goswami S, Sundar R, Jain M. Evaluation of adverse effects of lisinopril and rosuvastatin on hematological and biochemical analytes in wistar rats. Toxicol Int 2013; 20:170-6. [PMID: 24082511 PMCID: PMC3783684 DOI: 10.4103/0971-6580.117261] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective: Combination therapy of lisinopril and rosuvastatin may be an important concept in developing more effective strategies to treat and prevent atherosclerosis, coronary heart disease, and co-morbid metabolic disorders. The present study was designed to evaluate toxic effects of lisinopril and rosuvastatin alone or its combination therapy on hematological and biochemical analytes in Wistar rats. Materials and Methods: Forty-two rats were divided into seven groups, with each group comprising six rats. Rats were administered with lisinopril, rosuvastatin alone, or in-combination at two different doses. The blood samples were collected from rats after 21 days of oral administration of the drug/s and analyzed for various hematological and biochemical analytes. Results: Lisinopril alone and its combination treatment with rosuvastatin at high doses decreased hemoglobin and hematocrit. Rosuvastatin alone at high dose and its concomitant administration with lisinopril at two different doses showed increase in total white blood cells and absolute lymphocyte count and neutrophil count. Serum levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin were significantly increased in rosuvastatin alone and its combination with lisinopril at both the doses. Besides this, lisinopril treatment decreased serum levels of sodium and increased the levels of potassium. Serum creatine kinase (CK) levels were increased in the animals treated with rosuvastatin at both the doses. However, increased serum CK level because of rosuvastatin became normal with co-administration of lisinopril at low doses. Conclusion: Our results indicate that administration of lisinopril with rosuvastatin does not ameliorate hepatotoxicity caused by rosuvastatin. However, combination treatment reduces serum CK levels elevated due to rosuvastatin, implicating protective effect of combination treatment on myopathy at low doses.
Collapse
Affiliation(s)
- Hardik Dodiya
- Department of Pharmacology, Lallubhai Motilal College of Pharmacy, Navrangpura, Ahmedabad, Gujarat, India
| | | | | | | | | |
Collapse
|
46
|
Standard and intensive lipid-lowering therapy with statins for the primary prevention of vascular diseases: a population-based study. Eur J Clin Pharmacol 2013; 70:99-108. [DOI: 10.1007/s00228-013-1586-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 09/06/2013] [Indexed: 01/08/2023]
|
47
|
Zaharan NL, Williams D, Bennett K. Statins and risk of treated incident diabetes in a primary care population. Br J Clin Pharmacol 2013; 75:1118-24. [PMID: 22845189 DOI: 10.1111/j.1365-2125.2012.04403.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 07/23/2012] [Indexed: 12/29/2022] Open
Abstract
AIMS (i) To examine the incidence of new onset treated diabetes in patients treated with different types of statins and (ii) the relationship between the duration and dose of statins and the subsequent development of new onset treated diabetes. METHODS A retrospective cohort study was performed using the Irish Health Services Executive Primary Care Reimbursement Services national pharmacy claims database. Individuals who received any medicines were identified from January 2001 to January 2009 (n = 1 235 671). Patients newly treated with statins from 1 January 2002 to 31 December 2007 were identified (n = 239 628). Cases were identified as individuals newly treated with antidiabetic medication (n = 38 503). Adjusted hazards ratios (HR) with 95% confidence intervals (CI) were calculated to examine the association between statins (any vs. none) and time to new onset treated diabetes using Cox proportional hazard regression. The dose and duration response relationship between statins and new onset treated diabetes was examined using restricted spline functions to assess the linearity of the relationship. RESULTS Statin use was associated with an increased risk of new onset treated diabetes (HR = 1.18, 95% CI 1.15, 1.22). Increased risk of new onset treated diabetes was found with rosuvastatin (HR = 1.41, 95% CI 1.31, 1.52), atorvastatin (HR = 1.23, 95% CI 1.19, 1.27) and simvastatin (HR = 1.15, 95% CI 1.05, 1.25). There were statistically significant overall dose and duration effects for all statins, excepting fluvastatin, which only demonstrated a duration effect. CONCLUSION An increased risk of new onset treated diabetes was found in those treated with statins showing significant duration and dose effect. Further study is required to confirm this association.
Collapse
Affiliation(s)
- Nur Lisa Zaharan
- Department of Pharmacology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
| | | | | |
Collapse
|
48
|
Effects of atorvastatin and rosuvastatin on renal function: A meta-analysis. Int J Cardiol 2013; 167:2482-9. [DOI: 10.1016/j.ijcard.2012.05.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/16/2012] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
|
49
|
Lai ECC, Yang YHK, Lin SJ, Hsieh CY. Use of antiepileptic drugs and risk of hypothyroidism. Pharmacoepidemiol Drug Saf 2013; 22:1071-9. [DOI: 10.1002/pds.3498] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 07/16/2013] [Accepted: 07/17/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Edward Chia-Cheng Lai
- Institute of Clinical Pharmacy and Pharmaceutical Sciences; National Cheng Kung University; Tainan Taiwan
| | - Yea-Huei Kao Yang
- Institute of Clinical Pharmacy and Pharmaceutical Sciences; National Cheng Kung University; Tainan Taiwan
- Health Outcome Research Center; National Cheng Kung University; Tainan Taiwan
| | - Swu-Jane Lin
- Department of Pharmacy Administration, College of Pharmacy; University of Illinois at Chicago; Chicago IL USA
| | - Cheng-Yang Hsieh
- Institute of Clinical Pharmacy and Pharmaceutical Sciences; National Cheng Kung University; Tainan Taiwan
- Department of Neurology; Tainan Sin-Lau Hospital; Tainan Taiwan
| |
Collapse
|
50
|
Abstract
Rosuvastatin is one of the most potent statins available for reducing circulating low-density lipoprotein cholesterol (LDL-C) levels, which enables more high-risk patients to achieve their lipid goals. Its favorable balance of effects on atherogenic and protective lipoproteins and its pleiotropic effects, including anti-inflammatory and antioxidant effects and improvement in endothelial dysfunction, are associated with slowing of progression of atherosclerosis within the artery wall and have been translated into clinical benefits for cardiovascular outcomes. This review provides an update on the safety and the efficacy of rosuvastatin in recent large clinical trials. It appears that rosuvastatin has a beneficial effect on the progression of atherosclerosis across the clinical dosage range of 2.5–40 mg. It reduced cardiovascular events in relatively low-risk subjects with elevated high-sensitivity C-reactive protein and normal low-density lipoprotein cholesterol. As with other statins, rosuvastatin did not show overall benefit in terms of survival in patients with heart failure, but certain clinical or biochemical markers reflecting underlying disease characteristics may help to identify subgroups of patients that benefit from statin therapy. In patients with end-stage renal disease undergoing chronic hemodialysis, rosuvastatin had no effect on reducing cardiovascular events. Although there is a slightly increased risk of incident diabetes with this class of agents, the absolute benefits of statin therapy on cardiovascular events overweigh the risk in patients with moderate or high cardiovascular risk or with documented cardiovascular disease. As with other statins, rosuvastatin is an appropriate therapy in addition to antihypertensive treatment to reduce cardiovascular risk in hypertensive patients.
Collapse
Affiliation(s)
- Miao Hu
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Shatin, Hong Kong
| | | |
Collapse
|