Rosuvastatin (zita rezita rekuti Crestor, rinotengeswa neAstraZeneca) ndeimwe yeinonyanya kushandiswa statin mishonga.Kufanana nemamwe ma statins, rosuvastatin inonyorerwa kuvandudza mazinga eropa lipid uye kuderedza njodzi yemoyo.

Mukati memakore gumi ekutanga kana zvakadaro kuti rosuvastatin yaive pamusika, yaizivikanwa zvakanyanya se "yechitatu-chizvarwa statin," uye nekudaro seyakanyanya kushanda uye pamwe ichikonzera mishoma mhedzisiro yakaipa kupfuura mamwe akawanda statin mishonga.Sezvo makore akafamba uye sehumbowo kubva kumiyedzo yekiriniki yakaungana, kwakawanda kwekuda kwekutanga kweiyi statin chaiyo kwave kudzikamiswa.

Nyanzvi zhinji zvino dzinofunga nezve njodzi uye mabhenefiti erosuvastatin kunge akafanana neayo emamwe ma statins.Nekudaro, kune mashoma ekiriniki mamiriro umo rosuvastatin inogona kufarirwa.

Kushandiswa kweRosuvastatin

Iyo statin mishonga yakagadziridzwa kuderedza ropa cholesterol.Iyi mishonga inosunga nemakwikwi kune enzyme yechiropa inonzi hydroxymethylglutaryl (HMG) CoA reductase.HMG CoA reductase inotora chikamu-chinodzikamisa chikamu mukuumbwa kwecholesterol nechiropa.

Nekuvhara HMG CoA reductase, statins inogona kuderedza zvakanyanya LDL ("yakaipa") cholesterol kugadzirwa muchiropa, uye nokudaro inogona kuderedza LDL cholesterol mazinga eropa ne60%.Mukuwedzera, ma statins ane mwero anoderedza mazinga eropa triglyceride (neanenge 20-40%), uye anogadzira kuwedzera kudiki (anenge 5%) muropa mazinga eHDL cholesterol ("yakanaka cholesterol").

Kunze kweiyo ichangoburwa PCSK9 inhibitors, ma statins ndiwo ane simba zvakanyanya ekuderedza cholesterol anowanikwa.Uyezve, kusiyana nemamwe makirasi e-cholesterol-kuderedza zvinodhaka, kliniki miedzo yakaratidza kuti statin zvinodhaka zvinogona kuvandudza zvakanyanya migumisiro yenguva refu yevanhu vane yakagadziriswa coronary artery disease (CAD), uye vanhu vari pakati nepakati kana pangozi yekukura CAD. .

Statins inoderedzawo zvikuru ngozi yehosha dzemwoyo dzinotevera, uye kuderedza ngozi yokufa neCAD.(Iyo itsva PCSK9 inhibitors yakave yakaratidzwawo muRCTs yakakura yekuvandudza migumisiro yekliniki.)

Uku kugona kwema statins kuvandudza zvakanyanya mhedzisiro yekiriniki kunofungidzirwa kuti kunokonzeresa, zvishoma muchikamu, kubva kune vamwe kana ese avo asiri-cholesterol-kudzikisa mabhenefiti.Pamusoro pekudzikisa LDL cholesterol, ma statins anewo anti-inflammatory properties, anti-blood clotting effects, uye plaque-stabilizing properties.Uyezve, mishonga iyi inoderedza C-reactive protein mazinga, inovandudza huwandu hwevascular function, uye inoderedza ngozi yehupenyu hunotyisidzira cardiac arrhythmias.

Zvinonyanya kuitika kuti mabhenefiti ekiriniki anoratidzwa ne statin zvinodhaka anokonzerwa nekubatanidzwa kwavo cholesterol-kudzikisa mhedzisiro uye dzakasiyana-siyana dzakasiyana-siyana dzisiri-cholesterol mhedzisiro.

Rosuvastatin Yakasiyana Sei?

Rosuvastatin mushonga mutsva, unonzi "chizvarwa chechitatu" statin mushonga.Chaizvoizvo, ndiyo yakanyanya simba statin mushonga pamusika.

Simba rayo rehukama rinobva kune makemikari ayo maitiro, ayo anobvumira kuti isungirire zvakanyanya kuHMG CoA reductase, nokudaro ichiita kuvharika kwakazara kweiyo enzyme.Molecule yemorekuru, rosuvastatin inogadzira yakawanda LDL-cholesterol-kudzikisa pane mamwe ma statin mishonga.Nekudaro, hukuru hwakafanana hwekudzikisa-cholesterol hunogona kuwanikwa kuburikidza nekushandisa madhasi epamusoro emamwe akawanda ma statins.

Kana "yakanyanya" statin therapy ichidikanwa kusunda cholesterol mazinga akaderera sezvinobvira, rosuvastatin ndiyo inoenda-kune mushonga kune varapi vazhinji.

Kubudirira kweRosuvastatin

Rosuvastatin yakawana mukurumbira wekunyanya kushanda pakati pemishonga yema statin, kunyanya zvichibva pamhedzisiro yemakiriniki maviri ekuedzwa.

Muna 2008, kudhindwa kwechidzidzo cheJUPITER kwakawana kutariswa kwevanorapa moyo kwese kwese.Muchidzidzo ichi, vanhu vanopfuura 17,000 vane utano hwakanaka vaiva neropa reLDL cholesterol mazinga asi yakakwirira CRP mazinga akaitwa randomized kuti agamuchire 20 mg pazuva re rosuvastatin kana placebo.

Munguva yekutevera, vanhu vakarongedzerwa ku rosuvastatin havana kungoita zvakanyanya kuderedza LDL cholesterol mazinga uye CRP mazinga, asi ivo vaivewo nezviitiko zvishoma zvemoyo netsinga (kusanganisira kurwisa kwemoyo, sitiroko, kudiwa kweiyo revascularization maitiro sekuvhiya stent kana bypass, uye musanganiswa wekurova kwemoyo sitiroko, kana kufa kwemoyo), pamwe nekuderedza kufa kwezvikonzero zvese.

Ichi chidzidzo chaishamisa kwete chete nekuti rosuvastatin yakavandudza zvakanyanya mhedzisiro yekiriniki mune senge vanhu vane hutano, asiwo nekuti vanhu ava vaive vasina kukwirisa cholesterol mazinga panguva yekunyoresa.

Muna 2016, muyedzo weHOPE-3 wakaburitswa.Ichi chidzidzo chakanyoresa vanhu vanopfuura 12 000 vane ngozi imwe chete yeatherosclerotic vascular disease, asi kwete CAD yakawanda.Vatori vechikamu vakarongeka kuti vagamuchire rosuvastatin kana placebo.Pakupera kwegore, vanhu vanotora rosuvastatin vakave nekuderera kukuru kwemhedzisiro yekupedzisira (kusanganisira kusingafa kwechirwere chemoyo kana sitiroko, kana kufa kubva kuchirwere chemoyo).

Mune ese ari maviri miedzo iyi, randomisation kune rosuvastatin yakavandudza zvakanyanya mhedzisiro yekiriniki yevanhu vaive nenjodzi imwe chete kana kupfuura, asi pasina zviratidzo zvechirwere chemoyo chemoyo.

Zvinofanira kucherechedzwa kuti rosuvastatin yakasarudzwa nokuda kwemiedzo iyi kwete nokuti yakanga iri simba guru remishonga ye statin, asi (kunyanya muchikamu chikuru) nokuti miedzo yakatsigirwa naAstraZeneca, muiti we rosuvastatin.

Vazhinji nyanzvi dze lipid dzinotenda kuti mhedzisiro yezviyedzo izvi ingadai yakafanana dai imwe statin yakashandiswa pachiyero chakaringana, uye kutaura zvazviri, kurudziro yazvino pakurapa nemishonga yema statin kazhinji inobvumidza kushandiswa kwechero zvinodhaka zvinodhaka chero bedzi chipimo chemushonga chakakwira zvekusvika pachiyero chakafanana checholesterol-kudzikisa sezvaizoitwa nerosuvastatin yakaderera.(Kusiyana kune uyu mutemo mukuru kunoitika kana "intensive statin therapy" ichidanwa. Intensive statin therapy inonzwisiswa kuti inoreva rosuvastatin yepamusoro-dose kana high-dose atorvastatin, inova statin inotevera-simba zvikuru inowanikwa.)

Asi nekuda kwekuti rosuvastatin yaive chaiyo statin ndiyo yakashandiswa mune idzi mbiri dzakakosha miedzo yekiriniki, vanachiremba vazhinji vakatadza kushandisa rosuvastatin sechisarudzo chavo.

Current Zviratidzo

Statin therapy inoratidzwa kuvandudza mazinga eropa lipid (kunyanya, kuderedza LDL cholesterol uye / kana triglyceride mazinga), uye kudzivirira chirwere chemwoyo.Statins inokurudzirwa kune vanhu vane yakagadziriswa atherosclerotic yemwoyo chirwere, vanhu vane chirwere cheshuga, uye vanhu vane inofungidzirwa yemakore gumi mungozi yekuva nechirwere chemoyo chiri pamusoro pe7.5% kusvika 10%.

Nepo, kazhinji, iyo statin mishonga inoonekwa seyakachinjika maererano nekubudirira kwavo uye njodzi yavo yekukonzera zviitiko zvakashata, panogona kunge paine dzimwe nguva apo rosuvastatin ingafarirwa.Kunyanya, apo "high-intensity" statin therapy ine chinangwa chekudzikisa LDL cholesterol kusvika kune yakaderera mazinga anogoneka, ingave rosuvastatin kana atorvastatin pamatanho avo epamusoro edosi inowanzokurudzirwa.

Usati Watora

Usati wanyorerwa chero statin drug, chiremba wako achaita hurongwa hwekuongorora njodzi yekufungidzira njodzi yako yekuva nechirwere chemoyo uye achayera yako lipid mazinga eropa.Kana iwe uchitova nechirwere chemoyo kana kuti uri panjodzi yakakwira yekuchigadzira, chiremba wako angangokurudzira mushonga we statin.

Mimwe mishonga inowanzo nyorwa zvinosanganisira atorvastatin, simvastatin, fluvastatin, lovastatin, pitavastatin, uye pravastatin.

Crestor, iyo mhando yezita remhando yerosuvastatin kuUS, inodhura zvakanyanya, asi mageneric mafomu erosuvastatin ave kuwanikwa.Kana chiremba wako achida kuti utore rosuvastatin, bvunza kana uchikwanisa kushandisa jenariki.

Statins haifanirwe kushandiswa muvanhu vasingawirirani nema statins kana chero ipi zvayo yezvigadzirwa, vane nhumbu kana vanoyamwisa, vane chirwere chechiropa kana kutadza kwetsvo, kana vanonwa doro rakawandisa.Zvidzidzo zvinoratidza kuti rosuvastatin inogona kushandiswa zvakachengeteka muvana vanopfuura makore gumi.

Chiyero cheRosuvastatin

Kana rosuvastatin iri kushandiswa kuderedza yakakwira LDL cholesterol mazinga, kazhinji madosi akaderera anotanga (5 kusvika 10 mg pazuva) uye anogadziriswa kumusoro mwedzi wega wega kana maviri sezvinodiwa.Muvanhu vane mhuri hypercholesterolemia, vanachiremba vanowanzotanga nemwero wakakwira (10 kusvika 20 mg pazuva).

Kana rosuvastatin iri kushandiswa kudzikisa njodzi yechirwere chemoyo muvanhu vane njodzi yakakwira zvine mwero, chiyero chekutanga chinowanzo 5 kusvika 10 mg pazuva.Muvanhu vane njodzi inofungidzirwa kuti yakakwirira (kunyanya, ngozi yavo yemakore gumi inofungidzirwa kuva pamusoro pe7.5%), kurapa kwakanyanya kunowanzotangwa, ne 20 kusvika 40 mg pazuva.

Kana rosuvastatin iri kushandiswa kuderedza dambudziko rekuwedzera kwezviitiko zvemoyo mumunhu ane chirwere chemwoyo chakatosimbiswa, kurapwa kwakanyanya kunowanzo shandiswa nechiyero che 20 kusvika ku40 mg pazuva.

Muvanhu vanotora cyclosporine kana zvinodhaka zveHIV/AIDS, kana muvanhu vane itsvo dzakadzikira, muyero werosuvastatin unofanirwa kugadziriswa uchidzika, uye kazhinji haufanirwe kudarika 10 mg pazuva.

Vanhu verudzi rweAsia vanowanzove vanonyanya kunzwira tsitsi kune statin zvinodhaka uye zvakanyanya kutarisana nemhedzisiro.Zvinowanzokurudzirwa kuti rosuvastatin inofanira kutangwa pa5 mg pazuva uye kuwedzera zvishoma nezvishoma muvarwere vekuAsia.

Rosuvastatin inotorwa kamwe chete pazuva, uye inogona kutorwa mangwanani kana manheru.Kusiyana akati wandei emamwe emamwe ma statin mishonga, kunwa zvine mwero mwero wemuto wemuzambiringa hauna mhedzisiro parosuvastatin.

Zvikonzero zveRosuvastatin

Mumakore achangogadzirwa rosuvastatin, nyanzvi dzakawanda dzakafungidzira kuti statin mhedzisiro yaizove isinganyanyi kutaurwa nerosuvastatin, nekuda kwekuti yakaderera madosi inogona kushandiswa kuwana yakakwana kuderedza cholesterol.Panguva imwecheteyo, dzimwe nyanzvi dzakati statin mhedzisiro yaizokwidziridzwa nemushonga uyu, sezvo waive une simba kupfuura mamwe ma statins.

Mumakore apfuura, zvave pachena kuti hapana chirevo chaive chechokwadi.Zvinotaridza senge mhando uye hukuru hwehuipi hwakashata hunowanzo fanana nerosuvastatin sezvazviri nemamwe ma statin mishonga.

Statins, seboka, inobvumirwa zviri nani pane mamwe madhiragi ekuderedza cholesterol.Mune meta-analysis yakabudiswa muna 2017 iyo yakatarisa 22 randomized kliniki miedzo, chete 13.3% yevanhu vakangoerekana vatora statin drug vakarega mushonga nekuda kwemigumisiro mukati memakore mana, zvichienzaniswa ne13.9% yevanhu vakarongerwa ku placebo.

Zvakadaro, pane zvinonyatsozivikanwa zvinokonzeresa zvinokonzerwa ne statin mishonga, uye izvi mhedzisiro inowanzoshanda kune rosuvastatin pamwe nechero imwe statin.Izvo zvinonyanya kuzivikanwa zveizvi side effects zvinosanganisira:

• Zviitiko zvakashata zvine chekuita netsandanyama.Muscle toxicity inogona kukonzerwa nema statins.Zviratidzo zvinogona kusanganisira myalgia (kurwadziwa kwetsandanyama), kushaya simba kwetsandanyama, kuzvimba kwetsandanyama, kana (mune kashoma, zvakanyanya) rhabdomyolysls.Rhabdomyolysis ndiko kutadza kushanda zvakanaka kwerenal kunokonzerwa nekuparara kwemhasuru kwakanyanya.Kazhinji kazhinji.mhedzisiro ine tsandanyama inogona kudzorwa nekuchinja kune imwe statin.Rosuvastatin iri pakati pemishonga yemastatin inoita seinokonzeresa huturu hwemhasuru shoma.Kusiyana neizvi, lovastatin, simvastatin, uye atorvastatin zvinowanzokonzera kukonzera matambudziko emhasuru.
• Zvinetso zvechiropa.Inenge 3% yevanhu vanotora statins vachave nekuwedzera kwechiropa enzymes muropa ravo.Muvazhinji vevanhu ava, hapana humbowo hwekukuvadzwa kwechiropa chaihwo hunoonekwa, uye kukosha kwekukwira kudiki uku muma enzymes hakuna kujeka.Mune vanhu vashomanana, kukuvara kwakanyanya kwechiropa kwakataurwa;hazvisi pachena, zvisinei, kuti chiitiko chekukuvara kwakanyanya kwechiropa chakakwirira kune vanhu vanotora statins kupfuura muhuwandu hwevanhu.Iko hakuna chinoratidza kuti rosuvastatin inogadzira akawanda kana mashoma nyaya dzechiropa pane mamwe ma statins.
• Kusagadzikana kwepfungwa.Pfungwa yekuti ma statins anogona kukonzera kukanganisa kwenjere, kurasikirwa kwendangariro, kuora mwoyo, kushatirwa, hutsinye, kana zvimwe zvepakati tsinga mhedzisiro yakasimudzwa, asi haina kuratidzwa zvakajeka.Mukuongorora kwenyaya dzenyaya dzakatumirwa kuFDA, zvinofungidzirwa kuti matambudziko ekuziva ane chekuita nema statins anoita seakajairika ne lipophilic statin mishonga, kusanganisira atorvastatin, fluvastatin, lovastatin, uye simvastatin.Iyo hydrophilic statin mishonga, kusanganisira rosuvastatin, yakave yakabatanidzwa zvishoma kazhinji neichi chiitiko chakashata.
• Chirwere cheshuga.Mumakore achangopfuura, kuwedzera kudiki mukukura kwechirwere cheshuga kwakabatana ne statin therapy.A 2011 meta-analysis yemakiriniki mashanu miedzo inoratidza kuti imwezve nyaya yechirwere cheshuga inowanikwa muvanhu mazana mashanu vanobatwa nepamusoro-kusimba statins.Kazhinji, iyi dhigirii yengozi inoonekwa seyakagamuchirwa chero bedzi iyo statin inogona kutarisirwa kuderedza zvakanyanya njodzi yemoyo.

Mimwe mhedzisiro iyo yakajairika kutaurwa ne statin mishonga inosanganisira kusvotwa, manyoka, uye kurwadziwa kwemajoini.

Kudyidzana

Kutora mimwe mishonga kunogona kuwedzera njodzi yekuva nemhedzisiro nerosuvastatin (kana chero statin).Rondedzero iyi yakareba, asi mishonga inonyanyozivikanwa inodyidzana nerosuvastatin inosanganisira:

• Gemfibrozil, iyo isiri-statin cholesterol-inoderedza mumiririri
• Amiodarone, iyo inorwisa-arrhythmic drug
• Zvakawanda zvemishonga yeHIV
• Mamwe maantibioti, kunyanya clarithromycin uye itraconazone
• Cyclosporine, immunosuppressant drug

Izwi rinobva kuna Verywell

Nepo rosuvastatin iriyo yakanyanya simba statin iripo, kazhinji, kushanda kwayo uye chepfu chimiro chakafanana kune ese mamwe ma statins.Zvakadaro, kune mashoma emakiriniki mamiriro umo rosuvastatin inogona kufarirwa pane mamwe statin mishonga.