Statins offer limited short-term benefits
Click Here to Manage Email Alerts
Statin therapy appeared to be more beneficial in patients with a life expectancy of more than 2.5 years, a meta-analysis showed. The data also indicated that statins did not provide a mortality benefit.
Researchers wrote that their findings, published in JAMA Internal Medicine, underscore the importance of “individualizing statin treatment decisions by incorporating each patient’s values and preferences.”
In what researchers described as the first study to use quantitative methods to determine statins’ time to benefit, Lindsey C. Yourman, MD, a primary care physician and assistant professor of medicine at UC San Diego, and colleagues analyzed eight studies with 65,383 adults. The mean age of the participants ranged from 55 years to 69 years, and 66.3% of them were men. The participants were followed for a mean of 2 years to 6 years. According to researchers, the small number of previous studies that focused on older adults necessitated broadening the scope of their meta-analysis to include studies with younger adults.
“Statins are a very commonly prescribed medication and it's important for both patients and providers to know how long it will take until they will benefit from a statin,” Yourman told Healio Primary Care.
According to the researchers, only one of the eight analyzed studies showed that statins decreased all-cause mortality. In addition, 2.5 years (95% CI, 1.7-3.4) of statin use were needed to avoid one major adverse cardiovascular event among 100 patients without known CVD. To prevent one major adverse cardiovascular event for 200 patients treated with statins (absolute risk reduction = .005), the time to benefit was 1.3 (95% CI, 1-1.7) years, whereas the time to benefit to avoid one major adverse cardiovascular event for 500 patients treated (absolute risk reduction = .002) was 0.8 (95% CI, 0.5-1) year.
“Our time to benefit estimation and previously published studies suggest that statins have substantial benefits that accrue over time. Counterbalancing these benefits are the burdens and potential harms of statin therapy that usually occur within weeks of initiation,” the researchers wrote. “Because the potential harms of statins occur within weeks, whereas the benefits take years, adults aged 50 to 75 years with a life expectancy of less than 2.5 years may be more likely to be harmed than helped by statin therapy.”
The researchers noted that the evidence suggests statin therapy considerations should be tailored to each patient, rather than be one size fits all.
According to Yourman, “patients whose life expectancy is somewhere [between] 2 to 4 years, then my decision to prescribe would rest heavily upon their priorities, values and preferences. If that person is already feeling very overburdened by their care and wants to focus on what helps them feel better today (as opposed to 2 years), I may focus on other interventions with a shorter time to benefit such as physical therapy. If that person is not feeling burdened by their care and wants to do every intervention possible to avoid cardiovascular events in the future, then I'd be more inclined to prescribe.”