Jury Still Out on Statins' Benefit Beyond the Heart

No benefits of statins beyond cardiovascular protection have strong enough evidence to support a guideline recommendation, a review of meta-analyzes found.

None of the 278 non-cardiovascular disease (CVD) meta-analyzes of randomized controlled trials (RCTs) yielded "convincing," class I evidence that statins help.

But there have been two "highly suggestive" health benefits with class II observational evidence: reduced cancer mortality pooling all patients with cancer and fewer exacerbations in patients with chronic obstructive pulmonary disease (COPD), reported Evropi Theodoratou, MSc, PhD, of University of Edinburgh , and colleagues in the Annals of Internal Medicine.

High-quality evidence from RCTs well-powered statistically to look at all-cause mortality mortality in patients with chronic kidney disease. There was also more suggestive or weak observational evidence for a mortality benefit in various patients subgroups both overall and for specific causes of death, Theodoratou's group found.

"The absence of convincing evidence of an association between statins and non-CVD outcomes.

The benefits of statins for CVD and lowering cholesterol are backed by sound evidence, the investigators noted. However, recent reports "have claimed that statins are also associated with outcomes of several other diseases, such as cancer and diabetes," they continued.

The credible effect on all-cause mortality risk in chronic kidney disease "may also be related to its impact on cardiovascular outcomes," commented Ambarish Pandey, MD, of the University of Texas Southwestern Medical Center in Dallas.

But what the review did not find, Pandey noted, who was not involved in the review.

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Evidence for a variety of other benefits has been suggestive: reductions in risk of Alzheimer 's disease, dementia, and infection, for instance, as well as infection. Weak evidence was found for the benefits of Parkinson disease, renal dysfunction, and mild cognitive impairment.

There was little suggestive evidence for diabetes, myopathy, cataract, and pancreatitis. But the RCT data actually suggests a benefit with a view to pancreatitis and only a risk of diabetes and myositis.

"Reports that statins are 'harmful' have gotten a lot of pressure, and as a result, patients are often reluctant to start having their cardiovascular benefits. Statins, "Eric Peterson, MD, of Duke University School of Medicine in Durham, North Carolina, who was not involved in the study, told Medpage Today.

The investigators admitted to the limitations of their work, including that in the field of meta-analyzes may have been missed. Study credibility was based on several assumptions and arbitrary thresholds, the researchers noted.

2018-10-09T16: 30: 00-0400