News & Commentary

Meta-analysis Backs Statin Use


Not only have the dangers of statins been greatly exaggerated, according to a huge meta-analysis in the British Medical Journal, but there may also be benefits to the drugs other than their ability to lower cholesterol.

Researchers at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease looked at 20 studies published from November 1994 to March 2014 (http://www.bmj.com/content/349/bmj.g3743). For about five years, the studies tracked 150,000 middle-aged and older men and women who took statins.

“Although early concerns about statin-induced hepatotoxicity and cancer have subsided owing to reassuring evidence, two of the most common concerns that clinicians have are myopathy and diabetes,” the study states.

But those risks are actually minimal. “The increased risk of diabetes associated with statins seems to be confined mainly to people who are already at high risk of diabetes,” the study says. “Furthermore, all of the incident diabetes events occurred in patients who had at least one risk factor for diabetes: impaired fasting glucose, body mass index greater than 30, metabolic syndrome, or glycated hemoglobin greater than 6%.”

Regarding muscle aches, researchers cite one study in which “27% of patients whose statin was discontinued had a documented muscle-related side effect, yet nearly all of these patients were able to tolerate a re-challenge. The fact that symptoms often do not recur on re-challenge suggests that they are unrelated to the statin.”

On the other hand, the study says that statin use actually decreases the risk of pancreatitis. And it may not end there, because literature “is accumulating on the potential noncardiovascular benefits of statins, which could lead to novel applications of this class of drug.”

Nearly 200 million people in the world take statins, which, the study says, “form the pharmacologic cornerstone of the primary and secondary prevention of atherosclerotic disease.”

Researchers conclude: “On the basis of those data and our review of the noncardiovascular effects of statins, for most patients, the benefits of statins far outweigh the harms.”