Rosuvastatin (izina ryirango Crestor, ryacuruzwa na AstraZeneca) numwe mubiyobyabwenge bikoreshwa cyane. Kimwe nizindi statin, rosuvastatin yandikiwe kuzamura urwego rwamaraso ya lipide yumuntu no kugabanya ibyago byumutima.

Mu myaka icumi ya mbere cyangwa irenga ko rosuvastatin yari ku isoko, yavuzwe cyane nka "statin yo mu gisekuru cya gatatu," bityo rero ikaba ikora neza kandi bikaba bishoboka ko itera ingaruka nke ugereranije n’ibindi biyobyabwenge bya statin. Uko imyaka yagiye ihita kandi nkibimenyetso bivuye mu bigeragezo byo kwa muganga byakusanyije, ishyaka ryinshi ryo hambere kuri iyi statin ryarahindutse.

Abahanga benshi ubu basanga ingaruka ningaruka za rosuvastatin bisa cyane nizindi statin. Ariko, hariho ibintu bike byubuvuzi aho rosuvastatin ishobora guhitamo.

Imikoreshereze ya Rosuvastatin

Imiti ya statin yakozwe kugirango igabanye cholesterol mu maraso. Iyi miti ihuza amarushanwa na enzyme yumwijima yitwa hydroxymethylglutaryl (HMG) CoA reductase. HMG CoA reductase igira uruhare mukugabanya igipimo muguhuza cholesterol numwijima.

Muguhagarika HMG CoA reductase, statin irashobora kugabanya cyane umusaruro wa cholesterol ya LDL (“mbi”) mwumwijima, bityo bikagabanya urugero rwamaraso ya LDL ya cholesterol kugera kuri 60%. Byongeye kandi, statine igabanya mu buryo bworoheje urugero rwa triglyceride yamaraso (hafi 20-40%), kandi ikabyara kwiyongera (hafi 5%) murwego rwamaraso ya cholesterol ya HDL (“cholesterol nziza”).

Usibye inhibitori za PCSK9 ziherutse gukorwa, statin ni imiti igabanya cholesterol igabanya imbaraga ziboneka. Byongeye kandi, bitandukanye n’ibindi byiciro by’imiti igabanya cholesterol, ibizamini by’amavuriro byerekanye ko imiti ya statin ishobora kuzamura cyane umusaruro w’igihe kirekire cy’abantu bafite indwara zifata imitsi y’imitsi (CAD), ndetse n’abantu bafite ibyago byinshi cyangwa byinshi byo kwandura CAD .

Statins igabanya kandi cyane ibyago byo kurwara umutima, hanyuma bikagabanya ibyago byo gupfa na CAD. .

Ubu bushobozi bwa statin kugirango butezimbere cyane ibyavuye mubuvuzi bibwira ko bivamo, byibuze igice, bivuye kuri bimwe cyangwa byose mubyiza bitagabanya cholesterol. Usibye kugabanya cholesterol ya LDL, statin ifite kandi imiti irwanya inflammatory, ingaruka zo kwanduza amaraso, hamwe nimiterere ya plaque. Byongeye kandi, iyi miti igabanya poroteyine C-itera imbaraga, igateza imbere imikorere yimitsi muri rusange, kandi ikagabanya ibyago byo kurwara umutima byangiza ubuzima.

Birashoboka cyane ko inyungu zamavuriro zerekanwa nibiyobyabwenge bya statin biterwa no guhuza ingaruka za cholesterol zigabanya hamwe ningaruka zinyuranye ziterwa na cholesterol.

Nigute Rosuvastatin Atandukanye?

Rosuvastatin numuti mushya, bita "igisekuru cya gatatu" ibiyobyabwenge. Mu byingenzi, niwo muti ukomeye wa statin ku isoko.

Imbaraga zayo ugereranije zikomoka kumiterere yimiti, ituma ihuza cyane na reductase ya HMG CoA, bityo bigatuma habaho guhagarika byimazeyo iyi misemburo. Molekile ya molekile, rosuvastatin itanga LDL-cholesterol igabanya cyane kuruta indi miti ya statin. Nyamara, ubunini busa bwo kugabanya cholesterol burashobora kugerwaho ukoresheje dosiye ndende yizindi statin nyinshi.

Iyo hakenewe ubuvuzi bwa "intensique" bwa statin kugira ngo cholesterol igabanuke ku buryo bushoboka, rosuvastatin ni yo igana imiti ku baganga benshi.

Ingaruka za Rosuvastatin

Rosuvastatin yamamaye cyane mu miti ya statin, ahanini ishingiye ku bisubizo by’ibizamini bibiri by’amavuriro.

Muri 2008, gutangaza ubushakashatsi bwa JUPITER byitabiriwe naba psychologue hose. Muri ubu bushakashatsi, abantu barenga 17.000 bafite ubuzima bwiza bafite amaraso asanzwe ya LDL ya cholesterol ariko bakazamura urugero rwa CRP batoranijwe kugirango bahabwe mg 20 kumunsi ya rosuvastatin cyangwa umwanya wabo.

Mugihe cyakurikiranwe, abantu bahisemo kwisuzumisha kuri rosuvastatin ntabwo byagabanije cyane urugero rwa LDL ya cholesterol ya LDL ndetse na CRP, ariko kandi bari bafite ibibazo bike byindwara z'umutima (harimo n'indwara z'umutima, inkorora, gukenera uburyo bwo kuvugurura ibintu nka stent cyangwa kubagwa, hamwe no guhuza umutima, cyangwa urupfu rw'umutima n'imitsi), kimwe no kugabanuka kw'impfu zose.

Ubu bushakashatsi ntibwabaye gusa kubera ko rosuvastatin yazamuye cyane ibyavuye mu mavuriro ku bantu bigaragara ko bafite ubuzima bwiza, ariko nanone kubera ko abo bantu batazamuye urugero rwa cholesterol mu gihe cyo kwiyandikisha.

Muri 2016, urubanza HOPE-3 rwashyizwe ahagaragara. Ubu bushakashatsi bwakorewe ku bantu barenga 12.000 bafite byibura ikintu kimwe gishobora gutera indwara zifata imitsi ya Atherosclerotique, ariko nta CAD igaragara. Abitabiriye amahugurwa batoranijwe kugirango bakire rosuvastatin cyangwa umwanya wabo. Umwaka urangiye, abantu bafata rosuvastatine bagabanutse cyane mubisubizo byavuyemo (harimo n'indwara z'umutima zidapfa cyangwa inkorora, cyangwa urupfu rwindwara z'umutima-damura).

Muri ibyo bigeragezo byombi, kwanduza rosuvastatine byateje imbere cyane ibyavuye mu mavuriro y’abantu bafite impamvu imwe cyangwa nyinshi, ariko nta kimenyetso cy’indwara zifata umutima.

Twabibutsa ko rosuvastatin yatoranijwe muri ibyo bigeragezo atari ukubera ko ari yo yari ikomeye cyane mu biyobyabwenge bya statin, ariko (byibuze igice kinini) kubera ko iburanisha ryatewe inkunga na AstraZeneca, ukora rosuvastatin.

Abahanga benshi ba lipid bemeza ko ibyavuye muri ibyo bigeragezo byari kumera iyo iyindi statin ikoreshwa ku kigero gihagije, kandi mubyukuri, ibyifuzo biriho kubijyanye no kuvura imiti ya statin muri rusange byemerera gukoresha imiti iyo ari yo yose ya statin igihe cyose ibipimo ni byinshi bihagije kugirango ugere hafi kurwego rumwe rwo kugabanya cholesterol nkuko byagerwaho hamwe na dose yo hasi ya rosuvastatin. .

Ariko kubera ko rosuvastatin yari statin yakoreshejwe muribi bigeragezo byombi by’amavuriro, abaganga benshi banze gukoresha rosuvastatin nka statin bahisemo.

Ibyerekana

Ubuvuzi bwa statin bwerekanwe kunoza urugero rwamaraso ya lipide idasanzwe (byumwihariko, kugabanya cholesterol ya LDL na / cyangwa triglyceride), no kwirinda indwara zifata umutima. Imibare irasabwa kubantu barwaye indwara zifata umutima na Atherosclerotic zifata umutima, abantu barwaye diyabete, hamwe nabantu bafite ibyago byimyaka 10 yo kwandura indwara zifata umutima nimiyoboro iri hejuru ya 7.5% kugeza 10%.

Mugihe, muri rusange, ibiyobyabwenge bya statin bifatwa nkibishobora guhinduka ukurikije imikorere yabyo hamwe ningaruka zabo zo guteza ibintu bibi, hashobora kubaho igihe rosuvastatine ishobora guhitamo. By'umwihariko, iyo ubuvuzi bwa "high-ubukana" bugamije kugabanya cholesterol ya LDL kugeza kurwego rwo hasi rushoboka, yaba rosuvastatin cyangwa atorvastatine kurwego rwabo rwo hejuru rusabwa.

Mbere yo gufata

Mbere yuko uhabwa imiti iyo ari yo yose ya statin, umuganga wawe azakora isuzuma risanzwe rishobora kugereranya ibyago byo kwandura indwara z'umutima n'imitsi kandi azapima urugero rwa lipide y'amaraso. Niba usanzwe ufite indwara z'umutima-damura cyangwa ukaba ufite ibyago byinshi byo kwandura, umuganga wawe ashobora kuguha imiti ya statin.

Indi miti ya statin ikunze kwandikwa harimo atorvastatin, simvastatin, fluvastatin, lovastatin, pitavastatin, na pravastatin.

Crestor, izina ryizina rya rosuvastatin muri Amerika, rirahenze cyane, ariko uburyo rusange bwa rosuvastatin burahari. Niba umuganga wawe ashaka ko ufata rosuvastatin, baza niba ushobora gukoresha rusange.

Imibare ntigomba gukoreshwa mubantu bafite allergie ya statine cyangwa ikindi kintu cyose kibigize, batwite cyangwa bonsa, bafite indwara yumwijima cyangwa kunanirwa nimpyiko, cyangwa banywa inzoga nyinshi. Ubushakashatsi bwerekana ko rosuvastatin ishobora gukoreshwa neza mu bana barengeje imyaka 10.

Umubare wa Rosuvastatin

Iyo rosuvastatine ikoreshwa mukugabanya urugero rwa LDL ya cholesterol ya LDL, mubisanzwe dosiye yo hasi iratangira (mg 5 kugeza 10 mg kumunsi) hanyuma igahinduka hejuru buri kwezi cyangwa bibiri bibaye ngombwa. Ku bantu barwaye hypercholesterolemia yumuryango, mubisanzwe abaganga batangirana na dosiye iri hejuru (mg 10 kugeza kuri 20 kumunsi).

Iyo rosuvastatine ikoreshwa mu kugabanya ibyago byo kwandura indwara z'umutima n'imitsi ku bantu bafite ibyago byinshi byo hejuru, urugero rwo gutangira ni mg 5 kugeza 10 mg kumunsi. Mu bantu bafite ibyago bifatwa nkibyinshi (byumwihariko, ibyago byabo byimyaka 10 bivugwa ko biri hejuru ya 7.5%), ubuvuzi bwimbaraga nyinshi butangira, hamwe na mg 20 kugeza 40 mg kumunsi.

Niba rosuvastatin ikoreshwa mu kugabanya ibyago byo kwandura indwara z'umutima-damura ku muntu urwaye indwara zifata umutima-mitsi, ubuvuzi bukomeye bukoreshwa hakoreshejwe urugero rwa mg 20 kugeza kuri 40 kumunsi.

Mu bantu bafata cyclosporine cyangwa ibiyobyabwenge kuri virusi itera SIDA, cyangwa ku bantu bafite imikorere yimpyiko, urugero rwa rosuvastatine rugomba guhindurwa hepfo, kandi muri rusange ntirugomba kurenza mg 10 kumunsi.

Abantu bakomoka muri Aziya bakunda kumva cyane imiti ya statin kandi bakunda guhura n'ingaruka. Mubisanzwe birasabwa ko rosuvastatin igomba gutangirwa kuri mg 5 kumunsi kandi ikiyongera buhoro buhoro kubarwayi bo muri Aziya.

Rosuvastatin ifatwa rimwe kumunsi, kandi irashobora gufatwa haba mugitondo cyangwa nijoro. Bitandukanye nindi miti myinshi ya statin, kunywa umutobe winzabibu muke ntacyo uhindura kuri rosuvastatin.

Ingaruka Zuruhande rwa Rosuvastatin

Mu myaka yakurikiyeho rosuvastatine imaze gutunganywa, abahanga benshi bavuze ko ingaruka za statin zitagaragara cyane hamwe na rosuvastatine, gusa kubera ko dosiye yo hasi ishobora gukoreshwa kugirango cholesterol igabanuke. Muri icyo gihe kandi, izindi mpuguke zavuze ko ingaruka za statin zizakuzwa n’iki kiyobyabwenge, kubera ko cyari gikomeye kurusha izindi statin.

Mu myaka yashize, bimaze kugaragara ko nta na kimwe cyemeza. Irasa n'ubwoko n'ubunini bw'ingaruka mbi muri rusange ni kimwe na rosuvastatin nkuko bimeze no ku bindi biyobyabwenge bya statin.

Sitati, nk'itsinda, yihanganirwa kuruta indi miti igabanya cholesterol. Mu isesengura ryakozwe na meta ryasohowe mu 2017 ryarebye ibizamini 22 by’ubuvuzi byateganijwe, abantu 13.3% bonyine ni bo bonyine bahisemo kunywa ibiyobyabwenge bya statin bahagaritse ibiyobyabwenge kubera ingaruka mbi mu myaka 4, ugereranije na 13.9% by’abantu batabishaka.

Haracyariho, hari ingaruka zizwi zizwi ziterwa nibiyobyabwenge bya statin, kandi izi ngaruka mubisanzwe zikoreshwa kuri rosuvastatin kimwe nizindi statin. Ikigaragara cyane muri izi ngaruka zirimo:

• Imitsi ijyanye nibintu bibi. Uburozi bwimitsi burashobora guterwa na statine. Ibimenyetso bishobora kuba birimo myalgia (ububabare bwimitsi), intege nke z imitsi, gutwika imitsi, cyangwa (mubihe bidasanzwe, bikomeye) rhabdomyolysls. Rhabdomyolysis ni kunanirwa gukabije kwimpyiko guterwa no kugabanuka kwimitsi. Kenshi na kenshi. Ingaruka zijyanye n'imitsi zirashobora kugenzurwa no guhindura indi statin. Rosuvastatin iri mu biyobyabwenge bya statin bigaragara ko bitera ubumara buke bwimitsi. Ibinyuranye, lovastatin, simvastatin, na atorvastatine bikunze gutera ibibazo byimitsi.
• Ibibazo by'umwijima. Abantu bagera kuri 3% bafata statine bazagira imisemburo yumwijima mumaraso yabo. Muri benshi muri aba bantu, nta kimenyetso cyerekana ko umwijima wangiritse ugaragara, kandi akamaro k'ubwo butumburuke buto muri enzymes ntusobanutse. Mu bantu bake cyane, havuzwe ibikomere bikabije by'umwijima; ntibisobanutse ariko ko umubare w’imvune zikabije z’umwijima ari nyinshi ku bantu bafata statin kuruta mu baturage muri rusange. Nta kigaragaza ko rosuvastatin itanga ibibazo byinshi cyangwa bike byumwijima kurusha izindi statin.
• Ubumuga bwo kutamenya. Igitekerezo kivuga ko statin zishobora gutera ubumuga bwo kutamenya, guta umutwe, kwiheba, kurakara, kwibasirwa, cyangwa izindi ngaruka zo hagati ya nervice sisitemu yo hagati, ariko ntibyagaragaye neza. Mu isesengura rya raporo z’imanza zoherejwe muri FDA, ibibazo bivugwa mu bwenge bifitanye isano na statine bigaragara ko bikunze kugaragara cyane ku miti ya lipofilique, harimo atorvastatin, fluvastatin, lovastatin, na simvastatine. Imiti ya hydrophilique statin, harimo na rosuvastatin, ntabwo yagaragaye cyane hamwe nibi bintu bishobora kuba bibi.
• Diyabete. Mu myaka yashize, kwiyongera gake mu iterambere rya diyabete byajyanye no kuvura statin. Isesengura ryakozwe mu mwaka wa 2011 ryerekeye ibizamini bitanu by’amavuriro ryerekana ko umuntu umwe wongeyeho diyabete aboneka ku bantu 500 bavuwe na statine ifite ubukana bwinshi. Muri rusange, urwego rwibyago rushobora kwemerwa mugihe statin ishobora gutegurwa kugabanya cyane ibyago byumutima nimiyoboro y'amaraso.

Izindi ngaruka zikunze kuvugwa hamwe nibiyobyabwenge bya statin harimo isesemi, impiswi, hamwe nububabare.

Imikoranire

Gufata imiti imwe n'imwe birashobora kongera ibyago byo kwandura ingaruka hamwe na rosuvastatine (cyangwa statin iyo ari yo yose). Uru rutonde ni rurerure, ariko ibiyobyabwenge bizwi cyane bikorana na rosuvastatin birimo:

• Gemfibrozil, ikaba igabanya cholesterol itagabanya statin
• Amiodarone, ikaba ari imiti igabanya ubukana
• Imiti myinshi ya sida
• Antibiyotike zimwe na zimwe, cyane cyane Clarithromycine na itraconazone
• Cyclosporine, imiti ikingira indwara

Ijambo Ryiza cyane

Mugihe rosuvastatin niyo statin ikomeye cyane iboneka, muri rusange, imikorere yayo nuburozi bwuburozi burasa cyane nizindi statin zose. Nubwo bimeze bityo, hariho ibibazo bike byamavuriro aho rosuvastatine ishobora guhitamo kuruta imiti ya statin.