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Rhabdomyolysis after co‐administration of a statin and fusidic acid: an analysis of the literature and of the WHO database of adverse drug reactions

机译:联合应用他汀类药物和夫西地酸后的横纹肌溶解:文献分析和WHO药物不良反应数据库

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摘要

Following a severe case of rhabdomyolysis in our University Hospital after a co‐administration of atorvastatin and fusidic acid, we describe this interaction as this combination is not clearly contraindicated in some countries, particularly for long‐term treatment by fusidic acid. All cases of rhabdomyolysis during a co‐administration of a statin and fusidic acid were identified in the literature and in the World and Health Organization database, VigiBase®. In the literature, 29 cases of rhabdomyolysis were identified; mean age was 66 years, median duration of co‐administration before rhabdomyolysis occurrence was 21 days, 28% of cases were fatal. In the VigiBase®, 182 cases were retrieved; mean age was 68 years, median duration of co‐administration before rhabdomyolysis was 31 days and 24% of cases were fatal. Owing to the high fatality associated with this co‐administration and the long duration of treatment before rhabdomyolysis occurrence, fusidic acid should be used if there is no appropriate alternative, as long as statin therapy is interrupted for the duration of fusidic acid therapy, and perhaps a week longer. Rarely will interruption of this sort have adverse consequences for the patient.
机译:在阿托伐他汀和夫西地酸合用后,在大学医院发生严重的横纹肌溶解病例后,我们描述了这种相互作用,因为在某些国家,尤其是对于夫西地酸的长期治疗,这种组合并未被明确禁忌。在他汀类药物和夫西地酸合用期间发生横纹肌溶解的所有病例均在文献中以及在世界卫生组织的数据库VigiBase ®中得到确认。在文献中,鉴定出29例横纹肌溶解症。平均年龄为66岁,在横纹肌溶解发生之前共同给药的中位时间为21天,其中28%的病例是致命的。在VigiBase ®中,检索到了182个案例。平均年龄为68岁,横纹肌溶解前共同给药的中位时间为31天,其中24%的病例死亡。由于这种共同给药的高死亡率和横纹肌溶解发生之前的长期治疗,如果没有合适的替代方法,应使用夫西地酸,只要在他夫西酸治疗期间中断他汀类药物治疗,也许一个礼拜这种中断很少会给患者带来不良后果。

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