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"I was surprised by the number of results we identified as being related to statins," wrote in an e-mail the author of the study, Evropi Theodoratou, a researcher at the university. University of Edinburgh. "However, we have only identified a lack of convincing evidence that statins have a major role" in these findings.
The analysis revealed limited evidence of positive outcomes related to cancer, dementia, kidney disease and chronic obstructive pulmonary disease, called COPD. But only one of these findings was significant in a randomized trial – reducing all-cause mortality in patients with chronic renal failure – and the authors claim that it could still be motivated by the impact of drugs on cardiovascular diseases. the two often go together.
"Clinical guidelines already recognize the benefits of statins in preventing cardiovascular events in patients with chronic renal failure who are not undergoing dialysis, but clinical guidelines do not currently indicate statin use. to improve the prognosis of cancer or COPD, "Theodoratou said. . "I am unaware of any serious effort by doctors to redefine these guidelines."
More tests needed
Michael Pencina, vice-dean of data science and information technology at Duke University School of Medicine, said the analysis was important because people would invariably stay on statins for long periods of time. periods for the health of their heart, but the question remains statins are they doing well or bad?
"I think what we generally miss in the whole discussion about statins is the fully integrated risk-benefit analysis," said Pencina, who did not participate in the new study. .
Researchers say this does not mean that these results are not necessarily null; they just have not been tested enough yet.
Ahern noted that the new document omits studies conducted in a laboratory, which might contain important information. (The study indicates that there is "suggestive" evidence from observational analyzes that breast cancer survival without recurrence is related to statins.)
"In the end, I do not think that their findings fundamentally differ from our point of view, namely that it is high time that statins are definitely tested in breast cancer survivors as part of the program. a well-designed clinical trial, "said Ahern.
Advantages and disadvantages
Some statin patients report many side effects, such as muscle pain, increased blood sugar, and memory problems. But the majority of patients have no side effects.
"There has been a modest increase in diabetes in people treated with statins, but this evidence is not enough to justify the non-taking of drugs, which is consistent with the consensus of experts," Theodoratou said.
The new analysis did not detect any significant effect of the drugs on various side effects, including muscle pain. Theodoratou called it "reassuring", but cautioned that "we can not exclude the possibility that some of these injuries, such as muscle pain, are too rare to be excluded with certainty.
"We have not found strong evidence of an association, but not all of the initial studies reported side effects, so we can not conclude that the drugs do not cause of muscle pain, "she said.
The new document reviews previous meta-analyzes – Pencina called it a "summary of abstracts" – but does not closely evaluate individual studies, which may present their own selection bias, unfair monitoring, data missing, potential financial conflicts and the influence of.
Theodoratou says differences in study design and potential biases may explain why some findings, such as Alzheimer's disease, were significant in observational studies, but not in randomized trials. She also noted that the way in which researchers felt that the evidence was based primarily on "arbitrary thresholds, and at present, there is no gold standard … for to actually quantify the risk of bias. "
Ahern said, "They are very transparent about this," adding that the value of this analysis is determining where scientists should turn to better understand the impact of statins.
"Which of these benefits off-target should we spend our research budget and our efforts in pursuit?" He asked.
Similarly, Pencina called the new study a "generator of hypotheses" and said that it could be useful to better weigh the pros and cons of statins in people who take them for the health of their patients. heart.
Health experts say no pill, including statins, should replace healthy eating, exercise and avoid smoking – whose benefits go far beyond heart health, according to research .
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