Statins: more benefit or harm?
In the article Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database, published on May 20 in the online version of the British Medical Journal, professors of the University of Nottingham Julia Hippisley-Cox and Carol Coupland present the results of the analysis more than two million (!) medical histories of Britons aged 30 to 84 years, tracked for the period from January 2002 to June 2008. Approximately one in seven of the patients included in the QResearch database took various statins.
The authors evaluated the clinical effect of taking statins such as simvastatin (zocor), atorvastatin (lipitor), rosuvastatin (crestor), pravastatin and fluvastatin depending on the type, dose and duration of taking the drug and calculated the probability of a healing effect and the risks of developing specific side effects.
Scientists have not found a relationship between the use of statins and the risk of Parkinson's disease, rheumatoid arthritis, venous thromboembolism, dementia, fractures in osteoporosis and many types of cancer, including cancer of the stomach, intestines, lungs, kidneys, mammary glands and prostate. It turned out that taking statins reduces the risk of esophageal cancer.
The authors of the study revealed a significant relationship between taking statins and an increased risk of developing moderate and severe forms of liver, kidney dysfunction, myopathy (muscle tissue damage) and cataracts, and the severity of liver and kidney damage directly depended on the dose of statins taken.
For all the studied drugs, the probability of side effects was approximately the same, with the exception of fluvastatin, which is the most dangerous.
The increased risk of developing these diseases persisted throughout the course of statin treatment, but the first year of taking the drugs turned out to be especially dangerous.
According to the authors, for every 10,000 women at high risk of developing cardiovascular diseases and taking statins, there would be about 271 fewer cases of heart disease and 8 fewer cases of esophageal cancer. On the other hand, 74 women were at greater risk of liver dysfunction, 23 – acute renal failure, 307 – cataract and 39 – myopathy. The correlations found were also typical for men, with the exception of a higher risk of developing myopathy (not 39, but 110 additional cases).
The work of Hippisley-Cox and Kapland is important for the choice of preventive treatment strategies, taking into account the properties of specific drugs and the diseases existing in patients.
In another article by the same researchers, Individualizing the risks of statins in men and women in England and Wales: population-based cohort study, published on May 20 in the journal Heart, the authors demonstrated that the algorithm they developed can be used to identify patients at high risk of side effects when taking statins, as well as for more careful monitoring of the course of treatment of such patients.
In an accompanying article by the editor of Balancing the intended and unintended effects of statins, two well-known cardiologists express the opinion that, despite the fact that statins can cause side effects, their appointment, taking into account the results of the Hippisley-Cox and Kapland study, can bring more benefit than harm.
QStatin is an on–line calculator of the probability of developing various diseases and side effects when taking statins - doctors and anyone interested can find on the QIntervention website.
Daria Chervyakova
Portal "Eternal youth" http://vechnayamolodost.ru based on the materials of The University of Nottingham: Some statins have unintended effects and warrant closer monitoring, study finds
26.05.2010