請問大家Statin起始後，多久檢驗一次肝指數？
發表於 : 週二 9月 10, 2013 10:06 am
Statin起始後，4-6週驗GOT GPT?
之後沒6-12月驗一次？
Statin 的肝毒性，是dose-dependent? 或是使用時間長短？和水溶性、脂溶性有關？比較強的Rosuva Atorva 會比較產生肝毒性？
以上請教！
以下是爬文結果！
LFT should be carried out before and within 4-6 weeks of starting statin therapy (1). Thereafter at intervals of 6 months to 1 year - earlier if clinical features of hepatotoxicity; also at the first review at 4-6 weeks - enquire about adverse effects such as itching, rash, myalgia, arthralgia, insomnia (1)
if satisfactory lipid control and no evidence of adverse effects then review again at 4-6 months, then 6-12 monthly
if unsatisfactory lipid control then measurements should be repeated 6 weeks after dosage adjustments are made until the desired lipid concentrations are achieved (2)
however NICE state that LFTs only need to be measured on three occasions:
baseline liver enzymes should be measured before starting a statin. Liver function (transaminases) should be measured within 3 months of starting treatment and at 12 months, but not again unless clinically indicated
people who have liver enzymes (transaminases) that are raised but are less than 3 times the upper limit of normal should not be routinely excluded from statin therapy
treatment should be discontinued if serum transaminase concentrations rise to, and persist at, 3x normal range
之後沒6-12月驗一次？
Statin 的肝毒性，是dose-dependent? 或是使用時間長短？和水溶性、脂溶性有關？比較強的Rosuva Atorva 會比較產生肝毒性？
以上請教！
以下是爬文結果！
LFT should be carried out before and within 4-6 weeks of starting statin therapy (1). Thereafter at intervals of 6 months to 1 year - earlier if clinical features of hepatotoxicity; also at the first review at 4-6 weeks - enquire about adverse effects such as itching, rash, myalgia, arthralgia, insomnia (1)
if satisfactory lipid control and no evidence of adverse effects then review again at 4-6 months, then 6-12 monthly
if unsatisfactory lipid control then measurements should be repeated 6 weeks after dosage adjustments are made until the desired lipid concentrations are achieved (2)
however NICE state that LFTs only need to be measured on three occasions:
baseline liver enzymes should be measured before starting a statin. Liver function (transaminases) should be measured within 3 months of starting treatment and at 12 months, but not again unless clinically indicated
people who have liver enzymes (transaminases) that are raised but are less than 3 times the upper limit of normal should not be routinely excluded from statin therapy
treatment should be discontinued if serum transaminase concentrations rise to, and persist at, 3x normal range