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Question clinique
Is statin use associated with noncardiovascular disease benefits or risks?
L’Essentiel
Statin use may be associated with small decreases in cancer mortality, chronic obstructive pulmonary disease exacerbation, and all-cause mortality in patients with chronic kidney disease, but none of these benefits is large enough to be clinically relevant. Statins may also be associated with noncardiovascular disease (non-CVD) adverse effects, including a small increase in the development of diabetes and myopathy, but, again, these are not clinically important increases. 2a-
Référence
Plan de l'etude: Meta-analysis (other)
Financement: Self-funded or unfunded
Cadre: Various (meta-analysis)
Sommaire
To conduct this review, researchers searched 2 databases, Google Scholar, and bibliographies for English-language meta-analyses of observational and randomized trials that reported on non-CVD effects of statins. They identified 112 meta-analyses of observational studies and 144 meta-analyses of randomized studies that reported a total of 278 non-CVD outcomes. Three investigators selected studies for inclusion. One researcher extracted the data, which were checked by a second researcher. Using criteria characterized by the size of the P value and the number of patients, they found the highly suggestive results that statin use is associated with decreased cancer mortality in patients with cancer, decreased exacerbations in patients with chronic obstructive pulmonary disease, and decreased all-cause mortality in patients with chronic kidney disease. Observational studies also found suggestive evidence of an increase in diabetes and myopathy associated with statin use. Overall, though, as is often the case with observational studies, larger studies tended not to replicate findings of harm or benefit found in smaller studies, and even the statistically significant differences are clinically small.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Commentaires
statins should reserved for certain category of patients
only for diabetics,heart ,or hypertension patients
related to my practice
now i will use statine for only certain group of patients