Adverse Events With Statins Uncommon, Meta-Analysis Shows

[Zachariadis]

Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος
Michael O'Riordan
Jul 09, 2013

LONDON, UK — An analysis of nearly a quarter million individuals treated with statin therapy in 135 randomized, controlled clinical trials has shown that the lipid-lowering drugs are associated with a small increased risk of diabetes, but there was no evidence of an increased risk of cancer[1].

Overall, statins were well tolerated, according to the investigators, with the analysis indicating no evidence of an increased risk of myalgia, myopathy, or rhabdomyolysis. Head-to-head comparison showed that pravastatin and simvastatin had the lowest risk of adverse events vs atorvastatin and rosuvastatin (Crestor, AstraZeneca).

"At the population level, mortality and cardiovascular benefits of statin therapy greatly overweigh its potential harms--even taking into account the recent finding that statin use is associated with a modest increase in diabetes incidence," write Dr Huseyin Naci (London School of Economics and Political Science, UK) and colleagues in their analysis published online July 9, 2013 in Circulation: Cardiovascular Quality and Outcomes. "At the individual level, however, there may be a risk of exposing a large group of individuals to the (primarily minor) harms of statin therapy for the benefit of a smaller number of individuals."
As a class, statins were associated with a 9% increased risk of diabetes compared with patients treated with placebo (odds ratio 1.09; 1.02–1.16). In the placebo-controlled trials, the risk of diabetes was higher with rosuvastatin. However, this finding was not confirmed in the drug-level meta-analysis, in which there was no difference in risk of diabetes between statins.

Overall, there was no increased risk of cancer among statin-treated patients vs those who received a comparator drug, including placebo, and there was no evidence of any differences in risk with individual statins.

In terms of drug discontinuation caused by adverse events, subjects randomized to pravastatin and simvastatin were less likely to stop their medication compared with patients who received atorvastatin. Higher doses of atorvastatin resulted in more drug stoppages than atorvastatin 20 and 40 mg. However, drug discontinuations due to adverse events, myalgia, or elevations in creatinine kinase were not significantly higher among individuals who received statins vs those who did not.

In the meta-analysis, patients treated with statins were significantly more likely to have elevations in alanine aminotransaminase and aspartate aminotransaminase compared with controls. Higher doses of each drug were associated with greater risks of transaminase elevations.

"As a class, adverse events associated with statin therapy are not common. Statins are not associated with cancer risk, but do result in a higher odds of diabetes," conclude Naci et al. "Among individual statins, simvastatin and pravastatin appear safer and more tolerable than other statins."

The authors report they have no conflicts of interest.