Lack of evidence to support statin use in non-cardiovascular conditions

Although researchers found some evidence that statins may improve cancer survival in people taking them pre-diagnosis, there was a lack of convincing evidence overall, leading them to conclude that current recommendations should remain unchanged. 

Statins packet

There is a lack of ‘convincing’ evidence that statins improve outcomes in non-cardiovascular conditions, a review has shown.

The study looked at 112 meta-analyses of observational studies and 144 meta-analyses of randomised controlled trials (RCTs), exploring a total of 278 non-cardiovascular disease (non-CVD) outcomes.

The evidence for observational studies was grouped into four classes: ‘convincing’ (class I), ‘highly suggestive’ (class II), ‘suggestive’ (class III) and ‘weak’ (class IV).

The researchers found two ‘highly suggestive’ associations, including improved cancer survival in people who were already taking the drugs before diagnosis and reduced exacerbations in patients with chronic obstructive pulmonary disease.

But the remaining associations identified were classified as either ‘suggestive’ (n=21) or ‘weak’ (n=42) and there was no ‘convincing’ evidence of an association between statins and non-CVD outcomes. 

For the RCTs, only one outcome (reduced all-cause mortality in patients with chronic kidney disease) was classified as having high credibility.

Statins are licensed for the primary and secondary prevention of cardiovascular disease, but their growing use has led to interest in their potential effects on non-cardiovascular outcomes, the researchers explained.

They said that overall there was a lack of evidence that statins had a major role in the outcomes considered, such as Alzheimer’s disease, infection risk and prostate cancer recurrence.

“The absence of convincing evidence of an association between statins and non-CVD outcomes supports leaving the current recommendations unchanged,” the team wrote in Annals of Internal Medicine (online, 9 October 2018)[1]
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References

[1] He Y, Li X, Gasevic D et al. Statins and multiple noncardiovascular outcomes umbrella review of meta-analyses of observational studies and randomized controlled trials. Ann Intern Med 2018;169:543-553. doi: 10.7326/M18-0808

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Citation
Clinical Pharmacist, CP, December 2018, Vol 10, No 12;10(12):DOI:10.1211/PJ.2018.20205698