Thursday, April 14, 2011

Risks vs benefits of statins

A large BMJ population based cohort study was reported here.

Individual statins were not significantly associated with risk of Parkinson’s disease, rheumatoid arthritis, venous thromboembolism, dementia, osteoporotic fracture, and several common cancers
The risk of oesophageal cancer was reduced but for liver dysfunction, acute renal failure, myopathy, and cataract it was increased
Adverse effects were similar across the statin types for each outcome except liver dysfunction where fluvastatin was associated with the highest risks

The only thing new and concerning in this report that I'm aware of is the cataract risk. The muscle and renal risks can be managed by well established means of pharmacovigilance. Study after study has now demonstrated that the liver risk is not an outcome that matters clinically. The report did not address the growing body of evidence concerning statin benefits in various acute medical situations such as surgery and critical illness.

HT Clinical Cases and Images.

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