Are statins good or bad?
Launching what the Wall Street Journal yesterday said could be a year of "a statin backlash," researchers write in the current issue of the Archives of Internal Medicine about a growing body of evidence that these drugs interfere with patients' cognition.
However, in the same issue of Archives, another article describes the drugs' promising but not quite proven effects on fracture rates.
"There are reasons to think both favorable and adverse effects of statins and low cholesterol on cognition may pertain; the balance of these factors requires further elucidation," writes a research group that is studying cognitive effects of statins.
"A substantial body of literature links low cholesterol level to aggressive behavior; statin randomized trials have not supported a connection, but they have not been designed to address this issue. A limited number of reports suggest a connection between reduced cholesterol level and reduced serotonin level, but more information is needed with serotonin measures that are practical for clinical use. Whether lipophilic and hydrophilic statins differ in their impact should be assessed."
The NIH-funded trial described in this Archives article, the UCSD Statin Study, is underway, with results due out this spring, according to yesterday's Wall Street Journal.
"A number of critics believe drug companies have vastly understated side effects caused by statins-particularly muscle pains and memory problems," wrote reporter Tara Parker-Pope in her coverage of the biggest medical milestones likely this year.
"If, as expected, the research shows a higher rate of cognitive side effects than previously reported, doctors may finally start paying closer attention to the aches and pains of patients who use the drugs."
All the news is not bad for statins, however. Attempting to sort divergent evidence about whether use of statins is linked to fewer fractures, authors used meta-analysis to combine data from observational and cardiovascular studies.
Their conclusion is that the use of these agents provides "a consistent and clinically meaningful but nonsignificant reduction in hip and vertebral fractures in 4 prospective observational studies of older women," one that is not seen in women taking nonstatin lipid-lowering agents.
They add, "When these results were quantitatively combined with other studies of statin use and fracture, we observed a significant reduction in hip and nonspine fracture risk among statin users. These findings build on the recent reports that statins increase bone formation in rodents and suggest that statins may be useful agents for osteoporosis. Clinical trials are needed to test the ability of potent statins to prevent fracture."
Statins sunt bune sau rele? - Are statins good or bad? - articole medicale engleza - startsanatate