期刊
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
卷 84, 期 6, 页码 1128-1135出版社
WILEY
DOI: 10.1111/bcp.13539
关键词
coronary disease; effective dose 50 (ED50); dose response; ezetimibe; PCSK9 Inhibitors; statin
Statin doses around estimated effective dose 50 (ED50) can reduce myocardial infarction by over 25% and mortality by around 10%. Being a competitive enzyme inhibitor, statin efficacy plateaus at doses that are multiples above the ED50, whilst on- and off-target adverse events increase in number and severity with increasing dose. For example, myopathy has been shown to increase by up to 29-fold and liver dysfunction by up to nine-fold as statin dose is increased. Doses of up to 40-fold ED50 have been promoted, but above five-fold ED50, for example 10mg of atorvastatin, there is no randomized controlled clinical trial evidence that coronary mortality is lowered, or that survival is increased.
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