A comprehensive scientific review in The Lancet that balances the harms and benefits of statins will help clinicians and their patients make informed decisions about the drug class.
The review of the literature by researchers who have made substantial contributions to the science of statins concludes that lowering cholesterol by 2 mmol/L with an effective low-cost statin therapy for 5 years in 10,000 patients would:
Prevent major cardiovascular events in 1000 people with pre-existing vascular disease and in 500 people who are at increased risk but have not yet had a vascular event.
Cause 5 cases of myopathy (one of which might progress to rhabdomyolysis), 5-10 haemorrhagic strokes, 50-100 new cases of diabetes and up to 50-100 cases of symptomatic adverse events such as muscle pain.
The review also highlights the point that non-randomised evidence (used to undermine confidence in statins) has severe limitations.
Writing in a linked Comment, Dr Richard Horton, editor-in-chief of The Lancet likened the controversy around the safety and efficacy of statins to that of MMR, where false claims about the safety of a vaccine led to widespread vaccine hesitancy.
“One lesson of MMR was that, in the face of an unjustified claim that could harm public health, the scientific community, including journals, should respond quickly and robustly to counter that claim,” he wrote.
Some research papers are more high risk to public health than others, and as such, should be subjected to rigorous and extensive challenge during peer review, he added.