Statins are the UK’s most commonly prescribed drugs and are among the most widely prescribed drugs globally. Though their use in people at high risk of stroke and heart disease is uncontroversial, recent recommendations to treat much larger numbers of people at low risk have caused a storm of controversy. Most hotly debated are the nature and frequency of side effects of statins and whether arguably small gains in life expectancy are worth the risk.
Discontinuing treatment with statins in patients with terminal illnesses is safe, could improve quality of life, and could reduce costs, US research published in JAMA Internal Medicine concludes.
The pragmatic randomized trial looked at 381 patients with a mean age of 74.1 years. Half of the patients had cancer, and all had an estimated life expectancy of between one month and one year. The patients had been taking prescribed statins for three months or more for primary or secondary prevention of cardiovascular disease but had no recent active cardiovascular disease
Previous research has linked statins to a reduced risk of liver cancer, but much of the evidence has been from areas of the world with high rates of this type of cancer. So, researchers analysed data from the United Kingdom to investigate the effects of taking statins in a country with a relatively low incidence of liver cancer.
Risto Huupponen and Jorma Viikari
Some drugs taken to protect the heart may increase the risk of developing type-2 diabetes, according to researchers in Canada.
Their study of 1.5 million people, in the British Medical Journal, suggested powerful statins could increase the risk by 22% compared with weaker drugs.
Atorvastatin was linked to one extra case of diabetes for every 160 patients treated. Experts said the benefits of statins still outweighed any risks.
Statins in women
Do statins work as well as women as in men? A meta-analysis in Archives of Internal Medicine raises the possibility that they may not. Across 11 RCTs in 43,000 patients, statins as secondary prevention were associated with reduced risk of cardiovascular events in both sexes, but reductions in stroke and all-cause mortality were significant only in men. An accompanying Commentary is sceptical, arguing that other analyses have shown benefit to women, and that a better question would be whether the effect sizes are comparable. However, as an Editorial says, this question can only be answered by recruiting more women into trials.
Extract from OnMedica