Caution raised on statins in healthy people
pharmafile | January 20, 2011 | News story | Sales and Marketing | Cochrane, Crestor, Lipitor, statin, statin prescribing
Researchers have warned of a lack of evidence to support prescribing statins in patients at low risk of developing heart disease.
The Cochrane Library review concluded that evidence to support giving cholesterol-lowering drugs such as Pfizer’s Lipitor or AstraZeneca’s Crestor for ‘primary prevention’ of cardiovascular disease (CVD) was limited.
The analysis pooled data on 34,272 patients from 14 randomised controlled trials, and 11 of these examined the effects of statins in people with risk factors, including raised lipids, diabetes, hypertension, and microalbuminuria.
Statins are standard treatment for reducing high cholesterol, a risk factor for CVD, and the analysis found patients taking the drugs enjoyed a lower all-cause mortality rate, fewer heart attacks, strokes and a reduced need for revascularisation surgery.
But the researchers pointed out problems with many of the trials, including evidence of selective reporting of outcomes (‘cherry picking’), failure to report adverse events and inclusion of people with cardiovascular disease. The study also found no evidence of harm caused by statin prescriptions.
It concluded that caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk.
The Cochrane Collaboration evaluates medical research, and concluded in its review of previous studies that healthy people may derive no benefit from taking statins, but that they do reduce death rates.
The research was led by Fiona Taylor at the Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine.
“This current systematic review highlights the shortcomings in the published trials of statins for primary prevention. More attention should be given to studying possible cognitive impairment associated with use of statins,” she said.
The review points out that it is important trials examine potential adverse effects and report on them in an unbiased way.
It concluded: “Individual patient data meta-analyses have provided an initial appraisal of the evidence available to 2004. Further updates focusing on effects of statins among people without pre-existing disease and for a range of predicted CVD risk would help clarify the role of statins in primary prevention.”
Brett Wells
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