Statins have their place, review finds

There is no convincing evidence to support claims that statins can be used to manage non-cardiovascular health conditions, an extensive review has concluded.

The review was conducted by a large team of researchers led by geneticist Yazhou He from the University of Edinburgh. It was prompted by a number of studies conducted over the past decade or so that suggested possible roles for statins in the treatment or prevention on non-cardiac conditions, including vascular dementia, cancer, Parkinson’s disease and multiple sclerosis.

To test the strength of these claims, He and his colleagues identified 112 meta-analyses of observational studies and 144 meta-analyses of random controlled trials, which together identified 278 unique non-CVD conditions. All the studies had been included on either of two standard medical archives — MEDLINE and EMBASE – before a cut-off date of May 2018.

Analysing the observational studies, the researchers found “no convincing evidence” of replicated benefits for non-CVD conditions. They did, however, find two “highly suggestive” outcomes indicating, but not unambiguously so, that statins may have a positive effect in decreasing mortality in cancer patients and easing obstruction in patients with chronic obstructive pulmonary disease.

The analysis of the random controlled trials produced only one significant result – an indication of decreased all-cause mortality in patients with chronic kidney disease.

The observational results also suggested that statins could produce adverse affects in the form of diabetes and myopathy, or muscle weakness. However, the random controlled trial data did not throw up matching statistical evidence.

Over all, the researchers conclude that there is no strong evidence to warrant widening the range of conditions for which statins are prescribed.

“We report a dearth of convincing evidence that statins had a major role in the 278 unique non-CVD outcomes assessed,” they write.

The report is published in the journal Annals of Internal Medicine.

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