Rosuvastatin (izina ryirango Crestor, igurishwa na AstraZeneca) numwe mubiyobyabwenge bikoreshwa cyane.Kimwe nizindi statin, rosuvastatin yandikiwe kunoza urugero rwamaraso yumuntu no kugabanya ibyago byumutima.

Mu myaka icumi ya mbere cyangwa irenga rosuvastatin yari ku isoko, byamamaye cyane nka "statin yo mu gisekuru cya gatatu," bityo rero bikaba byiza kandi birashoboka ko bitera ingaruka nke ugereranije nibindi biyobyabwenge bya statin.Uko imyaka yagiye ihita kandi nkibimenyetso bivuye mubigeragezo byamavuriro byakusanyije, ishyaka ryinshi ryo hambere kuri statin ryarahindutse.

Abahanga benshi ubu basanga ingaruka ningaruka za rosuvastatin bisa nkibya 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 LDL ("mbi") ya cholesterol yumwijima, bityo irashobora kugabanya urugero rwa cholesterol ya LDL kugera kuri 60%.Byongeye kandi, statin igabanya mu buryo bworoheje urugero rwa triglyceride (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.Byongeye kandi, bitandukanye n’ibindi byiciro by’imiti igabanya cholesterol, ibizamini by’amavuriro byagaragaje ko imiti ya statin ishobora guteza imbere cyane ingaruka z’igihe kirekire cy’abantu bafite indwara zifata imitsi y’imitsi (CAD), hamwe n’abantu bafite ibyago byinshi cyangwa byinshi byo kwandura CAD .

Imibare igabanya kandi cyane ibyago byo kurwara umutima, hanyuma bikagabanya ibyago byo gupfa bivuye muri CAD.(Inhibitori nshya ya PCSK9 nayo yerekanwe muri nini ya RCT kugirango tunoze ivuriro.)

Ubu bushobozi bwa statin kugirango butezimbere cyane ibyavuye mu mavuriro bitekerezwa kuvamo, byibuze igice, uhereye kuri bimwe cyangwa byose mubyiza bitagabanya cholesterol.Usibye kugabanya cholesterol ya LDL, statin ifite kandi imiti igabanya ubukana, ingaruka zo kwanduza amaraso, hamwe nimiterere ya plaque.Byongeye kandi, iyi miti igabanya urugero rwa poroteyine C-itera imbaraga, igateza imbere imikorere yimitsi yose, kandi ikagabanya ibyago byo kurwara umutima.

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

Nigute Rosuvastatin Atandukanye?

Rosuvastatin numuti mushya, bita "generation-generation" 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 bikabuza cyane iyi misemburo.Molekile ya molekile, rosuvastatin itanga LDL-cholesterol igabanya imiti myinshi ya statin.Nyamara, ubunini busa bwa cholesterol-bugabanya bishobora kugerwaho ukoresheje dosiye ndende yizindi statin.

Iyo hakenewe ubuvuzi bwa "intensique" bwa statin kugira ngo cholesterol igabanuke cyane bishoboka, rosuvastatin niyo ijya kubiyobyabwenge kubaganga benshi.

Ingaruka za Rosuvastatin

Rosuvastatin yamamaye cyane mu miti ya statin, ishingiye ahanini ku bisubizo 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 yazamuye urugero rwa CRP batoranijwe kugirango bakire mg 20 kumunsi ya rosuvastatin cyangwa umwanya wabo.

Mugihe cyo kubikurikirana, abantu bahisemo kwisuzumisha kuri rosuvastatin ntibagabanije cyane urugero rwa cholesterol ya LDL hamwe na CRP, ariko kandi bari bafite ibibazo bike byumutima nimiyoboro y'amaraso (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 kugabanya impfu zose.

Ubu bushakashatsi ntibwabaye gusa kubera ko rosuvastatin yazamuye cyane ivuriro ry’abantu bigaragara ko bafite ubuzima bwiza, ariko nanone kubera ko aba bantu batigeze bongera urugero rwa cholesterol mugihe 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 Atherosclerotic, ariko nta CAD igaragara.Abitabiriye amahugurwa batoranijwe kugirango bakire rosuvastatin cyangwa umwanya wabo.Umwaka urangiye, abantu bafata rosuvastatin bagabanutse cyane mubisubizo byavuyemo (harimo n'indwara z'umutima zidapfa cyangwa inkorora, cyangwa urupfu rwindwara z'umutima).

Muri ibyo bigeragezo byombi, gutoranya rosuvastatin byateje imbere cyane ibyavuye mu mavuriro y’abantu bafite impamvu imwe cyangwa nyinshi, ariko nta kimenyetso cyindwara zifata umutima.

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

Abahanga benshi mu bya lipide bemeza ko ibyavuye muri ibyo bigeragezo byari kumera iyo indi statin ikoreshwa ku kigero gihagije, kandi mubyukuri, ibyifuzo byubu bijyanye 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 byubuvuzi, abaganga benshi banze gukoresha rosuvastatin nka statin yo guhitamo.

Ibyerekana

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

Mugihe, muri rusange, ibiyobyabwenge bya statin bifatwa nkigihinduka ukurikije imikorere yabyo hamwe ningaruka zabo zo guteza ibintu bibi, hashobora kubaho igihe rosuvastatin ishobora guhitamo.By'umwihariko, iyo "ubukana-bwinshi" bwo kuvura statin bugamije kugabanya cholesterol ya LDL kugeza kurwego rwo hasi rushoboka, haba rosuvastatin cyangwa atorvastatin kurwego rwabo rwo hejuru rusabwa.

Mbere yo gufata

Mbere yuko uhabwa imiti iyo ari yo yose ya statin, umuganga wawe azakora isuzuma ryibyago kugirango agereranye ibyago byo kwandura indwara z'umutima n'imitsi kandi azapima urugero rwa lipide.Niba usanzwe ufite uburwayi bw'umutima cyangwa ufite ibyago byinshi byo kurwara, umuganga wawe ashobora kuguha imiti ya statin.

Ibindi biyobyabwenge bisanzwe byandikirwa 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 kuri statine cyangwa ikindi kintu cyose kibigize, batwite cyangwa bonsa, bafite indwara yumwijima cyangwa kunanirwa kwimpyiko, cyangwa banywa inzoga nyinshi.Ubushakashatsi bwerekana ko rosuvastatin ishobora gukoreshwa neza mubana barengeje imyaka 10.

Igipimo cya Rosuvastatin

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

Iyo rosuvastatin ikoreshwa mukugabanya ibyago byindwara zifata umutima nimiyoboro yabantu bafite ibyago byo hejuru, urugero rwo gutangira ni mg 5 kugeza 10 mg kumunsi.Mu bantu bafite ibyago bifatwa nkaho ari byinshi (byumwihariko, ibyago byabo byimyaka 10 bivugwa ko biri hejuru ya 7.5%), imiti ivura ubukana bwinshi iratangira, hamwe na mg 20 kugeza kuri 40 kumunsi.

Niba rosuvastatin ikoreshwa kugirango igabanye ibyago byongera umutima wamaraso kumuntu urwaye indwara yumutima nimiyoboro y'amaraso, mubisanzwe ubuvuzi bukoreshwa hamwe na mg 20 kugeza 40 mg kumunsi.

Mu bantu bafata cyclosporine cyangwa ibiyobyabwenge kuri VIH / SIDA, cyangwa kubantu bafite imikorere yimpyiko, urugero rwa rosuvastatine rugomba guhindurwa hepfo, kandi muri rusange ntigomba kurenza mg 10 kumunsi.

Abantu bakomoka muri Aziya bakunda kumva cyane imiti ya statin kandi bakunze guhura n'ingaruka.Mubisanzwe birasabwa ko rosuvastatine 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 bigira kuri rosuvastatin.

Ingaruka Zuruhande rwa Rosuvastatin

Mu myaka ako kanya rosuvastatine imaze gutunganywa, abahanga benshi batangaje ko ingaruka za statin zitazagaragara cyane hamwe na rosuvastatin, gusa kubera ko dosiye yo hasi ishobora gukoreshwa kugirango cholesterol igabanuke.Muri icyo gihe, 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 hamwe byari ukuri.Irasa nubwoko nubunini bwingaruka mbi mubisanzwe ni kimwe na rosuvastatin nkuko bimeze kubindi biyobyabwenge bya statin.

Sitati, nk'itsinda, irihanganirwa kuruta indi miti igabanya cholesterol.Mu isesengura ryakozwe na meta ryasohowe mu 2017 ryarebye ibizamini 22 byateganijwe ku mavuriro, abantu 13.3% bonyine ni bo bonyine bahinduye imiti ya statin bahagaritse ibiyobyabwenge kubera ingaruka mbi mu myaka 4, ugereranije na 13.9% by’abantu batoranijwe kuri platbo.

Haracyariho, hari ingaruka zizwi neza 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 kubamo myalgia (ububabare bwimitsi), intege nke z imitsi, gutwika imitsi, cyangwa (mubihe bidasanzwe, bikomeye) rhabdomyolysls.Rhabdomyolysis ni impyiko zikaze ziterwa no kumeneka gukabije 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 statin 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 ntibisobanutse.Mu bantu bake cyane, havuzwe igikomere gikomeye cy'umwijima;ntibisobanutse ariko ko abantu bakomeretsa umwijima ari benshi ku bantu bafata statin kurusha abaturage muri rusange.Nta kigaragaza ko rosuvastatin itanga ibibazo byinshi cyangwa bike byumwijima kuruta izindi statin.
• Ubumuga bwo kutamenya.Igitekerezo kivuga ko statin ishobora gutera ubumuga bwo kutamenya, guta umutwe, kwiheba, kurakara, kwibasirwa, cyangwa izindi ngaruka zo mu mitsi 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 ku miti ya lipofilique, harimo atorvastatin, fluvastatin, lovastatin, na simvastatine.Imiti ya hydrophilique statin, harimo na rosuvastatin, ntiyagize uruhare runini hamwe nibi bintu bishobora kuba bibi.
• Diyabete.Mu myaka yashize, kwiyongera gake mu iterambere rya diyabete byajyanye no kuvura statin.Ubushakashatsi bwakozwe na 2011 mu bushakashatsi bwakozwe ku mavuriro atanu bwerekana ko indwara imwe ya diyabete ibaho ku bantu 500 bavuwe na statine nyinshi.Muri rusange, urwego rwibyago rushobora kwemerwa mugihe statin ishobora gutegurwa kugabanya cyane ibyago byumutima nimiyoboro.

Izindi ngaruka zikunze kuvugwa hamwe nibiyobyabwenge bya statin harimo isesemi, impiswi, hamwe no kubabara hamwe.

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