12 September 2016
A major new report has offered evidence that the benefit-risk profile of statin therapies may be much more positive than current perceptions would suggest.
Research from the University of Oxford and the London School of Hygiene & Tropical Medicine has been published in The Lancet, indicating that the benefits of the cholesterol-reducing drug for heart health are greater than previously assumed, while the danger posed by side effects is often being overstated.
The team aimed to analyse the impact of lowering people's cholesterol with an effective low-cost statin therapy such as atorvastatin for five years among 10,000 patients. It was estimated that this would prevent major cardiovascular events - such as heart attacks, ischaemic strokes and coronary artery bypasses - in 1,000 people with pre-existing vascular disease, as well as in 500 people who are at increased risk of disease due to age, hypertension or diabetes, but have not yet experienced a vascular event.
By contrast, only around 50 to 100 cases of symptomatic adverse events such as muscle pain would be expected in the same cohort, with more serious side effects including 50 to 100 new cases of diabetes, five to ten haemorrhagic strokes and around five cases of myopathy.
Although it was accepted that further research might reveal additional beneficial or adverse effects, they are unlikely to be significant enough to alter the overall positive benefit-risk profile that this study has demonstrated.
Conclusions based on previous observational studies indicated that statin therapy might increase the risks of various conditions such as memory loss, cataracts, kidney injury, liver disease, sleep disturbance, aggression, suicidal behaviour, erectile dysfunction and neuropathy, but the evidence from this research was unable to establish a causal relationship between statin therapy and any of these conditions.
Professor Rory Collins of the clinical trial service unit at the University of Oxford said: "Our review shows that the numbers of people who avoid heart attacks and strokes by taking statin therapy are very much larger than the numbers who have side effects with it. In addition, whereas most of the side effects can be reversed with no residual effects by stopping the statin, the effects of a heart attack or stroke not being prevented are irreversible and can be devastating.
"Consequently, there is a serious cost to public health from making misleading claims about high side effect rates that inappropriately dissuade people from taking statin therapy, despite the proven benefits."
Currently, it is estimated that around six million people take statins in the UK as a means of reducing the buildup of fatty plaques that can lead to blockages in blood vessels. Around two million of these patients are taking them because they have already had a heart attack, stroke or another cardiovascular event, with the remainder receiving the treatment because they are considered to be at high risk of heart problems.
Based on the findings of this study, it is estimated that as many as two million more patients across the country could also benefit from taking statins.
Posted by Jeanette Royston
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