Non-CVD statin evidence lacking

A review of the benefits of statins has found a lack of convincing evidence for the drugs’ use in helping prevent conditions such as cancer and Alzheimer’s disease

While some studies suggest benefits for conditions beyond cardiovascular disease, the authors – from Monash University and the UK’s University of Edinburgh – say the evidence does not support revising current statin prescribing guidelines.

They set out to evaluate the quantity, validity and credibility of evidence around statins and non-CVD outcomes, using meta-analyses of observational studies and randomised controlled trials examining non-CVD outcomes of statin therapy.

“Two investigators extracted data from meta-analyses and individual studies,” they wrote in Annals of Internal Medicine.

“Credibility assessments based on summary effect sizes from a random-effects model, between-study heterogeneity, 95% prediction interval, small-study effect, excess significance, and credibility ceilings were devised to classify evidence.

“This review explored 278 unique non-CVD outcomes from 112 meta-analyses of observational studies and 144 meta-analyses of RCTs.

“For observational studies, no convincing (class I) evidence, 2 highly suggestive (class II) associations (decreased cancer mortality in patients with cancer and decreased exacerbation in patients with chronic obstructive pulmonary disease), 21 suggestive (class III) associations, and 42 weak (class IV) associations were identified.

“One outcome from the RCTs (decreased all-cause mortality in patients with chronic kidney disease) attained a sufficient amount of evidence with no hints of bias.

“For adverse events, observational studies showed suggestive evidence that statins increase the risk for diabetes and myopathy.

“Among the RCTs, no statistically significant effects were found on myopathy, myalgia, or rhabdomyolysis.”

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