Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9492810.26442/2075-1753_19.10.89-95ArticlesСтатьиResearch ArticleStatins and the liver: a point of view from the gastroenterologistСтатины и печень: взгляд гастроэнтерологаKazyulinA. NКазюлинАлександр Нисонович

д-р мед. наук, проф., акад. РАЕН, проф. каф. пропедевтики внутренних болезней и гастроэнтерологии

alexander.kazyulin@yandex.ruA.I.Evdokimov Moscow State Medical and Dental University of the Ministry of Health of the Russian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И.Евдокимова» Минздрава России151020171910VOL 19, NO10 (2017)ТОМ 19, №10 (2017)899528122021Copyright ©; 2017, Consilium MedicumCopyright ©; 2017, ООО "Консилиум Медикум"2017Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94928

Millions of people in the world should be given statins, and these drugs are taken by the large group of patients. Objective information concerning any adverse event associated with statin drugs is very important, because even the data showing low liver toxicity rate can lead to abrupt withdrawal or dose interruption of these life-saving drugs in a significant number of patients with increased risk of acute cardiovascular events. Statins are the agents of choice because of the existence of a dose-dependent effect and have the most significant hypolipidemic effect, and doctors can prescribe statins in a reduced dosing regimen. On the other hand, the needed drug is exposed to the minimal metabolism via the cytochrome P450 system and this can prevent the overloading of this system, drug metabolism disorders and development toxic (drug-induced) hepatitis. These effects are associated with rosuvastatin application. Rosuvastatin has the low frequency of unwanted drug reactions and best hypolipidemic activity of this class of drugs.

Во всем мире миллионы людей нуждаются в приеме статинов, и значительная часть больных принимают эти препараты. Объективная информация о любых нежелательных явлениях, вызванных приемом статинов, чрезвычайно важна, поскольку новость даже о небольшой частоте случаев гепатотоксичности приводит к отмене или временному прекращению приема этих жизненно важных препаратов у значительного числа больных, что сопровождается повышением риска острых сердечно-сосудистых событий. Наличие дозозависимого эффекта делает препаратом выбора статин, обладающий наиболее выраженным гиполипидемическим действием, что позволит назначать его в меньшей дозе. С другой стороны, преимущество имеет препарат, подвергающийся минимальному метаболизму в системе цитохрома Р450, что предотвратит перегрузку данной системы, нарушение метаболизма лекарственных средств и развитие токсического (лекарственного) гепатита. Данные эффекты полностью присущи розувастатину, отличающемуся низкой частотой нежелательных лекарственных реакций при наибольшей для данного класса препаратов гиполипидемической активности.

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