Rosuvastatin (sunan mai suna Crestor, wanda AstraZeneca ke kasuwa) yana ɗaya daga cikin magungunan statin da aka fi amfani dashi. Kamar sauran statins, an wajabta rosuvastatin don haɓaka matakan lipid na jinin mutum da rage haɗarin cututtukan zuciya.

A cikin shekaru goma na farko ko makamancin haka, rosuvastatin yana kasuwa, an yi la'akari da shi azaman "statin na ƙarni na uku," don haka yana da inganci kuma yana iya haifar da ƙarancin illa fiye da sauran magungunan statin. Kamar yadda shekaru suka wuce kuma kamar yadda shaida daga gwaje-gwajen asibiti suka taru, yawancin sha'awar farko ga wannan takamaiman statin ya zama daidaitacce.

Yawancin masana yanzu suna la'akari da haɗarin dangi da fa'idodin rosuvastatin sun yi kama da na sauran statins. Koyaya, akwai fewan yanayi na asibiti waɗanda za'a iya fifita rosuvastatin.

Amfani da Rosuvastatin

An kirkiro magungunan statin don rage cholesterol na jini. Waɗannan magungunan suna ɗaure gasa ga enzyme hanta da ake kira hydroxymethylglutaryl (HMG) CoA reductase. HMG CoA reductase yana taka rawa mai iyakancewa a cikin haɗin cholesterol ta hanta.

Ta hanyar toshe HMG CoA reductase, statins na iya rage yawan samar da LDL ("mara kyau") cholesterol a cikin hanta, don haka zai iya rage matakan LDL cholesterol na jini da kusan 60%. Bugu da ƙari, statins suna rage matakan triglyceride na jini a hankali (da kusan 20-40%), kuma suna haifar da ƙaramin karuwa (kimanin 5%) a cikin matakan jini na HDL cholesterol ("cholesterol mai kyau").

Banda masu hana PCSK9 da aka ɓullo da kwanan nan, statins sune mafi ƙarfin rage ƙwayar cholesterol da ake samu. Bugu da ƙari kuma, ya bambanta da sauran nau'o'in kwayoyi masu rage cholesterol, gwaje-gwaje na asibiti sun nuna cewa magungunan statin na iya inganta sakamako na dogon lokaci na mutanen da ke fama da cututtuka na jijiyoyin jini (CAD), da kuma mutanen da ke da matsakaici ko haɗari na bunkasa CAD. .

Statins kuma yana rage haɗarin bugun zuciya na gaba, kuma yana rage haɗarin mutuwa daga CAD. (Sabbin masu hana PCSK9 suma an nuna su a cikin manyan RCTs don inganta sakamakon asibiti.)

Ana tsammanin wannan ikon na statins don inganta sakamako na asibiti yana haifar da, aƙalla a wani ɓangare, daga wasu ko duk fa'idodin da ba su rage cholesterol ba. Baya ga raguwar LDL cholesterol, statins kuma suna da kaddarorin anti-inflammatory, anti-blood clotting effects, da plaque-stabilizing Properties. Bugu da ƙari kuma, waɗannan magungunan suna rage matakan sunadarin C-reactive, inganta aikin jijiyoyin jini gaba ɗaya, da rage haɗarin arrhythmias na zuciya mai barazana ga rayuwa.

Da alama fa'idodin asibiti da magungunan statin suka nuna sun kasance saboda haɗuwa da tasirin rage ƙwayar cholesterol da nau'ikan tasirin su na marasa cholesterol.

Ta yaya Rosuvastatin ya bambanta?

Rosuvastatin sabon abu ne, wanda ake kira "tsara na uku" maganin statin. Mahimmanci, shine mafi ƙarfin maganin statin a kasuwa.

Ƙarfin dangi yana samuwa daga halayen sinadarai, wanda ke ba shi damar ɗaure da ƙarfi ga HMG CoA reductase, don haka yana haifar da cikakken hana wannan enzyme. Molecule don kwayoyin, rosuvastatin yana samar da ƙarin LDL-cholesterol-ragewa fiye da sauran magungunan statin. Koyaya, ana iya samun irin wannan girma na rage cholesterol ta amfani da mafi girman allurai na yawancin sauran statins.

Lokacin da ake buƙatar maganin statin na "tsanani" don tura matakan cholesterol a matsayin ƙasa kaɗan, rosuvastatin shine maganin zuwa ga likitoci da yawa.

Amfanin Rosuvastatin

Rosuvastatin ya sami sunan kasancewa mai tasiri musamman a tsakanin magungunan statin, galibi dangane da sakamakon gwaji na asibiti guda biyu.

A cikin 2008, buga binciken JUPITER ya sami hankalin likitocin zuciya a ko'ina. A cikin wannan binciken, sama da mutane 17,000 masu lafiya waɗanda ke da matakan LDL na jini na al'ada amma matakan CRP masu girma sun kasance bazuwar don karɓar ko dai 20 MG kowace rana na rosuvastatin ko placebo.

A yayin bin diddigin, mutanen da aka bazu zuwa rosuvastatin ba kawai sun rage yawan matakan LDL cholesterol da matakan CRP ba, amma kuma sun sami raguwar abubuwan da ke faruwa na zuciya da jijiyoyin jini (ciki har da bugun zuciya, bugun jini, buƙatar tsarin sake dawo da jijiyoyin jini kamar stent ko aikin tiyata). da haɗuwa da bugun jini na bugun zuciya, ko mutuwar zuciya), da kuma raguwar mace-mace duka.

Wannan binciken ya kasance mai ban mamaki ba kawai saboda rosuvastatin yana inganta sakamako na asibiti a cikin mutane masu lafiya a fili ba, har ma saboda waɗannan mutanen ba su da haɓakar matakan cholesterol a lokacin yin rajista.

A cikin 2016, an buga gwajin HOPE-3. Wannan binciken ya yi rajista a kan mutane 12,000 tare da aƙalla haɗari guda ɗaya don cututtukan cututtukan jijiyoyin bugun gini, amma ba CAD ba. An ba da izini ga mahalarta don karɓar ko dai rosuvastatin ko placebo. A ƙarshen shekara, mutanen da ke shan rosuvastatin sun sami raguwa sosai a cikin ƙarshen ƙarshen sakamako (ciki har da ciwon zuciya mara mutuwa ko bugun jini, ko mutuwa daga cututtukan zuciya).

A cikin waɗannan gwaje-gwajen guda biyu, bazuwar zuwa rosuvastatin yana haɓaka sakamakon asibiti na mutanen da ke da alaƙa ɗaya ko fiye, amma babu alamun cututtukan cututtukan zuciya.

Ya kamata a lura cewa an zaɓi rosuvastatin don waɗannan gwaje-gwajen ba don ita ce mafi ƙarfi na magungunan statin ba, amma (aƙalla a cikin babban sashi) saboda gwajin ya ɗauki nauyin AstraZeneca, wanda ya yi rosuvastatin.

Yawancin masana kimiyyar lipid sun yi imanin cewa sakamakon waɗannan gwaje-gwajen zai kasance iri ɗaya ne idan an yi amfani da wani statin a isasshe, kuma a zahiri, shawarwarin yanzu game da jiyya tare da magungunan statin gabaɗaya suna ba da damar amfani da kowane ɗayan magungunan statin muddin Sashi yana da girma sosai don cimma kusan daidai matakin rage cholesterol kamar yadda za'a samu tare da ƙaramin adadin rosuvastatin. (Baya ga wannan ka'ida ta gaba ɗaya yana faruwa ne lokacin da ake buƙatar "maganin statin mai ƙarfi".

Amma saboda da gaske rosuvastatin shine statin da aka yi amfani dashi a cikin waɗannan gwaje-gwajen asibiti masu mahimmanci guda biyu, likitoci da yawa sun ƙi yin amfani da rosuvastatin azaman statin ɗin zaɓin su.

Alamomi na yanzu

Ana nuna magungunan statin don inganta matakan lipid na jini mara kyau (musamman, don rage LDL cholesterol da / ko matakan triglyceride), da kuma hana cututtukan zuciya. Ana ba da shawarar Statins ga mutanen da ke fama da cututtukan zuciya na atherosclerotic, mutanen da ke da ciwon sukari, da mutanen da aka kiyasta haɗarin shekaru 10 na haɓaka cututtukan zuciya sama da 7.5% zuwa 10%.

Duk da yake, gabaɗaya, ana ɗaukar magungunan statin masu canzawa dangane da tasirin su da haɗarin haifar da mummunan al'amura, ana iya samun lokutan da za a fi son rosuvastatin. Musamman, lokacin da aka yi nufin rage yawan ƙwayar cholesterol na LDL zuwa mafi ƙanƙanta matakan da zai yiwu, ko dai rosuvastatin ko atorvastatin a cikin kewayon mafi girman adadin su gabaɗaya ana ba da shawarar.

Kafin Dauka

Kafin a umarce ku da kowane magani na statin, likitan ku zai gudanar da kima na haɗarin haɗari don kimanta haɗarin ku na haɓaka cututtukan zuciya kuma zai auna matakan lipid na jini. Idan kun riga kuna da cututtukan zuciya ko kuma kuna cikin haɗarin haɓaka ta, wataƙila likitanku zai ba da shawarar maganin statin.

Sauran magungunan statin da aka saba amfani dasu sun hada da atorvastatin, simvastatin, fluvastatin, lovastatin, pitavastatin, da pravastatin.

Crestor, nau'in sunan alamar rosuvastatin a cikin Amurka, yana da tsada sosai, amma nau'ikan rosuvastatin yanzu suna samuwa. Idan likitanku yana so ku ɗauki rosuvastatin, tambayi idan za ku iya amfani da nau'in jinsin.

Kada a yi amfani da statins a cikin mutanen da ke fama da rashin lafiyar statins ko wani abu daga cikin sinadaran su, masu ciki ko masu shayarwa, masu ciwon hanta ko gazawar koda, ko kuma masu shan barasa mai yawa. Nazarin ya nuna cewa ana iya amfani da rosuvastatin lafiya a cikin yara sama da shekaru 10.

Maganin shafawa na Rosuvastatin

Lokacin da ake amfani da rosuvastatin don rage haɓakar matakan LDL cholesterol, yawanci ana fara ƙananan allurai (5 zuwa 10 MG kowace rana) kuma ana daidaita su sama kowane wata ko biyu kamar yadda ya cancanta. A cikin mutanen da ke fama da hypercholesterolemia na iyali, likitoci yawanci suna farawa da ɗan ƙaramin allurai (10 zuwa 20 MG kowace rana).

Lokacin da ake amfani da rosuvastatin don rage haɗarin cututtukan zuciya da jijiyoyin jini a cikin mutanen da ke da matsakaicin haɗari, adadin farawa yawanci shine 5 zuwa 10 MG kowace rana. A cikin mutanen da aka yi la'akari da haɗarin su yana da girma (musamman, an kiyasta haɗarin shekaru 10 a sama da 7.5%), ana fara yawan farfadowa mai tsanani, tare da 20 zuwa 40 MG kowace rana.

Idan ana amfani da rosuvastatin don rage haɗarin ƙarin abubuwan cututtukan zuciya a cikin mutumin da ya riga ya kamu da cututtukan zuciya, ana amfani da magani mai ƙarfi tare da kashi 20 zuwa 40 MG kowace rana.

A cikin mutanen da ke shan cyclosporine ko kwayoyi don HIV / AIDs, ko a cikin mutanen da ke da ƙarancin aikin koda, ana buƙatar daidaita adadin rosuvastatin zuwa ƙasa, kuma gabaɗaya bai kamata ya wuce 10 MG kowace rana ba.

Mutanen asalin Asiya sun fi kula da magungunan statin kuma sun fi fuskantar illa. Gabaɗaya an ba da shawarar cewa yakamata a fara rosuvastatin a 5 MG kowace rana kuma a hankali a hankali a cikin marasa lafiya na Asiya.

Ana ɗaukar Rosuvastatin sau ɗaya kowace rana, kuma ana iya ɗaukar shi ko dai da safe ko da dare. Ba kamar sauran magungunan statin ba, shan ruwan 'ya'yan itacen inabi kaɗan yana da ɗan tasiri akan rosuvastatin.

Side Effects na Rosuvastatin

A cikin shekaru da yawa bayan haɓakar rosuvastatin, ƙwararrun masana da yawa sun ba da sanarwar cewa tasirin sakamako na statin zai ragu da rosuvastatin, kawai saboda ana iya amfani da ƙananan allurai don samun isasshen ƙwayar cholesterol. A lokaci guda kuma, wasu masana sun yi iƙirarin cewa za a haɓaka tasirin statin tare da wannan magani, tunda yana da ƙarfi fiye da sauran statins.

A cikin shekarun da suka shige, ya bayyana cewa babu wata magana da ta yi daidai. Yana kama da nau'in da girman tasirin illa gabaɗaya kusan iri ɗaya ne da rosuvastatin kamar yadda yake da sauran magungunan statin.

Statins, a matsayin rukuni, sun fi kyau jurewa fiye da sauran kwayoyi masu rage cholesterol. A cikin meta-bincike da aka buga a cikin 2017 wanda ya kalli gwaje-gwaje na asibiti 22 bazuwar, kawai 13.3% na mutanen da aka bazu zuwa maganin statin sun dakatar da maganin saboda illa a cikin shekaru 4, idan aka kwatanta da 13.9% na mutanen da aka bazu zuwa placebo.

Har yanzu, akwai sanannun illolin da magungunan statin ke haifarwa, kuma waɗannan illolin gabaɗaya sun shafi rosuvastatin da duk wani statin. Mafi shahara daga cikin waɗannan illolin sun haɗa da:

• Abubuwan da ke da alaƙa da tsoka. Ana iya haifar da guba na tsoka ta hanyar statins. Alamun na iya haɗawa da myalgia (ciwon tsoka), raunin tsoka, kumburin tsoka, ko (a cikin lokuta masu wuya, mai tsanani) rhabdomyolysls. Rhabdomyolysis shine babban gazawar koda wanda ya haifar da mummunan rauni na tsoka. A mafi yawan lokuta. Ana iya sarrafa illolin da ke da alaƙa da tsoka ta hanyar canzawa zuwa wani statin. Rosuvastatin yana cikin magungunan statin waɗanda ke haifar da ƙarancin ƙwayar tsoka. Sabanin haka, lovastatin, simvastatin, da atorvastatin sun fi saurin haifar da matsalolin tsoka.
• Matsalolin hanta. Kimanin kashi 3% na mutanen da ke shan statins zasu sami karuwa a cikin enzymes hanta a cikin jininsu. A mafi yawan waɗannan mutane, ba a ga shaidar ainihin lalacewar hanta ba, kuma mahimmancin wannan ƙananan haɓaka a cikin enzymes ba a sani ba. A cikin mutane kaɗan, an sami rahoton raunin hanta mai tsanani; ba a bayyana ba, duk da haka, cewa abin da ya faru na mummunan rauni na hanta ya fi girma a cikin mutanen da ke shan statins fiye da yawan jama'a. Babu wata alama da ke nuna cewa rosuvastatin yana haifar da al'amuran hanta fiye da sauran statins.
• Rashin hankali. Ra'ayin cewa statins na iya haifar da rashin fahimta, asarar ƙwaƙwalwar ajiya, damuwa, rashin tausayi, zalunci, ko wasu tasirin tsarin juyayi na tsakiya ya taso, amma ba a nuna shi a fili ba. A cikin nazarin rahotannin shari'ar da aka aika zuwa FDA, matsalolin fahimi da ake zargi da ke da alaƙa da statins sun bayyana sun zama ruwan dare tare da magungunan lipophilic statin, ciki har da atorvastatin, fluvastatin, lovastatin, da simvastatin. Magungunan statin hydrophilic, gami da rosuvastatin, ba a taɓa yin su da yawa akai-akai tare da wannan mummunan lamari.
• Ciwon sukari. A cikin 'yan shekarun nan, ƙananan haɓakar haɓakar ciwon sukari an danganta shi da maganin statin. Binciken meta-bincike na 2011 na gwaje-gwajen asibiti guda biyar ya nuna cewa ƙarin shari'ar ciwon sukari guda ɗaya yana faruwa a cikin kowane mutum 500 da aka yi wa magani tare da statins masu ƙarfi. Gabaɗaya, ana ɗaukar wannan matakin haɗarin karɓuwa muddin ana iya tsammanin statin zai rage haɗarin cututtukan zuciya gaba ɗaya.

Sauran illolin da aka saba ba da rahoto tare da magungunan statin sun haɗa da tashin zuciya, gudawa, da ciwon haɗin gwiwa.

Mu'amala

Shan wasu magunguna na iya ƙara haɗarin haɓaka sakamako masu illa tare da rosuvastatin (ko kowane statin). Wannan jeri yana da tsayi, amma mafi mashahuri magungunan da ke hulɗa da rosuvastatin sun haɗa da:

• Gemfibrozil , wanda ba shi da statin cholesterol-ragewan wakili
• Amiodarone, wanda shine maganin arrhythmic
• Yawancin magungunan HIV
• Wasu maganin rigakafi, musamman clarithromycin da itraconazone
• Cyclosporine, maganin rigakafi

Kalma Daga Sosai

Duk da yake rosuvastatin shine mafi ƙarfin statin da ake samu, gabaɗaya, tasirin sa da bayanin mai guba yayi kama da duk sauran statins. Duk da haka, akwai wasu yanayi na asibiti waɗanda za a iya fifita rosuvastatin akan sauran magungunan statin.