Statins

[Bazile]

There was some info in the press recently , with respect to new research into Statins ; which indicated amongst other things , that one of the side effects of taking statins may be the development of cancer .

What's the general scientific opinion now ?

[Sqad]

There are many reasons that I could give you for NOT taking statins, carcinogenesis is not one of them.

There is scientific evidence to suggest that statins MAY prevent certain malignancies....malignant melanoma is one.

The evidence for statins causing malignant disease is difficult to find in reputable research, but no doubt one could be found.

Let us hope that a scientist sees this thread and adds a bit more meat to my paltry answer.

[boxtops]

Bazile, equally there is research which suggests that the statin can reduce recurrence of prostate cancer.... http://scienceblog.ca...te-cancer-recurrence/

My GP is helpful to me in comparing risks and benefits. One of the suggested side-effects of statins is a marginal (3%) risk of cataracts, and since I was diagnosed with the beginnings of one in January, I wanted to know more when I went for my last cholesterol tests. He was more concerned that it could be late on-set diabetes causing the eye problem, but it isn't - but we discussed the risks and agreed that because my cholesterol reading is borderline (5.1) I would stay on the statin - the benefits to my cardiovascular network for me outweigh the other risks.
There are side-effects and risks with many treatment (I had the breast cancer discussion with him when I was on HRT), you have to weigh up the benefits against the known marginal risks and decide which is the better option.

[scotman]

I can only relate my own experience. I have been taking 10mg of Simvastatin for several years with no problems. About 3 months ago the dose was increased to 20mg and within weeks I started to get pain in leg muscles and cramps. I stopped taking them altogether and pain gradually went.
I now have prescription for Atorvastatin as alternative so will see how that goes. It seems that muscle ache is not uncommon with statins.

[theprof]

I'm with Sqad on this one.

Current thinking does point to the fact that statins may indeed have what you might call anti-cancer properties. Without getting too technical, hey have been shown to hinder a key pathway involved in critical, permanent changes in cell function and there is some evidence of their value in pancreatic, colorectal and lung cancers as well as leukaemia along with other encouraging features.

Having said all that, the evidence is far from conclusive and much more research is needed in this area - my university has two running right now.

If you want to read more about this, I'd suggest you try an internet search for a study titled:

"Statins and cancer: A systematic review and meta-analysis".

The authors are Jaana Kuoppalaa, Anne Lamminpääb and and Eero Pukkala. For my learned colleagues, the paper was published in October 2008 in the European Journal of Cancer, 44, 15, pp 2122-2132 and can be read on Science Direct

To the best of my knowledge, there's been nothing disagreeing with the conclusions of the cited paper in the scientific press recently. I can't speak for the more sensational newspapers I'm afraid. If you can find the article Bazile, I'd be grateful if you can provide further details.

[Bazile]

I beleive this was the report , prof

http://www.medicalnew...m/articles/189551.php

It looks like there were no risks associated with the medications with respect to cancer, from the extract below

However the increased risks identified, was what had concerned me ( reading it again ) - i.e serious liver dysfunction / renal failure

extract
'' They found there was no noteworthy link between use of individual statins and risk of Parkinson's disease, rheumatoid arthritis, venous thrombo-embolism, dementia, osteoporotic fracture, or many cancers including gastric, colon, lung, renal, breast or prostate. There was a reduced risk associated with statin use for oesophageal cancer.

However, they did detect an increased risk associated with statins use for:

* Moderate or serious liver dysfunction
* Moderate or serious acute renal failure
* Moderate to serious myopathy
* Cataracts
* And evidence of a dose response for acute renal failure and liver dysfunction with higher doses being associated with greater risk ''

Whats your opinion on the report , particularly , the serious problems identified ?

[theprof]

Anyhow, I've taken the opportunity to look at the original article in the BMJ to which your link refers. The article is actually titled "Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database" by Hippisley-Cox and Coupland. BMJ 2010:340:c2/97

I've reviewed the article and methodologies employed and I can say that the paper has revealed very little further information over and above what doctors' knew about statins anyway at the time of publication. The study objective was to quantify the unintended effects of statins according to type, dose, and duration of use and information from 368 participating GP surgeries was obtained electronically via the EMIS clinical information system.

Hippisley-Cox is a well known epidemiologist and Coupland is a leading UK academic statistician and the purpose of the study predominantly was to perform a statistical analysis of data about patients undergoing statin therapy via their GP.

I won't bore you with the statical analysis methods used as they are very complex to the unfamiliar and the article. The statistical modelling used was quite standard for this type of study.

AS I said, the gist of the article has been known to medical practitioners for years. For those with access to the physicians vade-mecum, The British National Formulary, the BNF discusses the importance of many of the diseases cited prior to prescribing statins. The prescriber is also obliged to be aware of standard cautionary recommendations before prescribing statins to patients as statins are not suitable for all. The issue of rhabdomyolysis and myalgia is common to all statins

[theprof]

Many of the conditions cited in the article are mentioned in the PIL (Patient Information Leaflet) that legally has to be included in the statin packaging for the patient to read before taking the tablets ( Well, that's the idea anyway!) In general, if the prescriber is unaware that the patient has, for example, liver disease, it's been found that a reasonable percentage of patients will query the wisdom of prescribing the statin by returning to ask the GP or pharmacist for advice.

There's nothing ground-breaking about the study. Such articles when cited in the popular or quasi-scientific press often cause alarm but the alarm is rarely justified. The drug protection agencies in the UK are reasonably good at their job and regularly review all prescribed drugs to ensure the public are not at risk.

At no point does the original article assert that there is a noteworthy link between statins and any type of cancer. Therefore, it's incorrect to state that "one of the side effects of taking statins may be the development of cancer". As I said, the increased risks to the organs cited via your extract do exist but have been known for years.

[theprof]

The article concludes by stating that patients at risk should receive the lowest possible dose of statin - errr, a good doctor will do this anyway.

I'm afraid the sort of hazards described in the article require the same careful assessment by prescriber as the thousands of prescriptions for other drugs prescribed daily by physicians.

Finally, I think I should say that I'm no supporter of statins as I consider the benefits may not outweigh the risks. I told my GP a few years back that I would not take a low-dose statin under any circumstances.

Incidentally, apologies for the missing first lines at the start of my reply. They were:

"Sorry I didn't get back to you earlier Bazile, but MrsProf had a meeting at GOSH and I had to run her into London as her car was in for a service."

[theprof]

I think I should also disclose that the QResearch Database is a facility wholly owned by
Hippisley-Cox.

[mike11111]

This has given me food for thought. I was prescribed statins just over a year ago (10mg Pravastatin per day). Apart from HBP and late on-set diabetes (Type 2) I had had no real medical problems yet a few months later I became very ill, eventually diagnosed as acute pancreatitis resulting in the removal of my gall bladder. Just wondered if the statins had anything to do with it. At the time I believe the routine prescription of statins was being promoted by the medical profession as a safeguard against strokes in people of a certain age.

[Bazile]

Many thanks for that prof .

In a previous post of mine , you stated that you had taken a daily dose of a statin for over 20 years .
Have you changed your mind over the wisdom of taking them ?

[theprof]

Yes I have Bazile. I began to suffer from quite a few of the side-effects of statin therapy such as myalgia, myositis, cramps and gastro-intestinal disturbances. MrsProf is a renowned expert on stain therapy and after some lengthy discussions, she suggested I discontinue treatment. My GP did not object as he knows MrsProfs formidable reputation!

Within weeks, my symptoms began to subside and I'm now more or less back to normal.

I will not condemn statins per se as I readily accept that they are can be a lifesaver to certain groups of people. However, they are not suitable for all patients and I disagree with the decision to allow them to be purchased by the general public at any UK pharmacy.

The following webpage provides a good account of many of the symptoms encountered by patients on statin therapy:

http://www.maturetimes.co.uk/node/10323

[theprof]

Hmm MrsProf is a renowned expert on "statin therapy" not "stain therapy" whatever that is!

[Bazile]

Thanks prof

A few years ago I had a TIA .
After various tests , the only thing that the doctors found , was that i had a hole in the heart .
I had an operation to close it with a device inserted somewhere in the heart .

They then put me on atorvastation and aspirin .

Would you mind asking Mrs Prof , if it would be advisable to remain taking the statin ?

Thanks

[theprof]

MrsProf tells me that based on the information provided, there is no clinical reason for you to stop the statin therapy.

[Bazile]

Again , thanks prof

regarding your answer -

'' ...there is no clinical reason for you to stop the statin therapy ''

Just for the avoidance of doubt and for the purposes of clarification - should the above read ? -

'' ...there is no clinical reason for you NOT to stop the statin therapy ''

[theprof]

No, it shouldn't Bazile as that would mean the converse as I read it. in essence, the message is that your post does not include any justification for stopping popping the statin. Keep taking the tablets if you feel ok on them.

Have a look at the Patient information leaflet enclosed with your tablets when you have a few minutes to spare. It will give you some idea about what to watch out for.

[Bazile]

Understood

Thank you

I guess , reading the possible side effects , ( e.g. renal failure - my dad died from this ) i'm aprehensive about taking said medication

[mike11111]

I'm definitely going to ask my GP if I can stop taking them. She prescribed them shortly before withdrawing my Bendrofluizide which I was taking with Perindopril for HBP, as a blood test had shown a slight deterioration in kidney function. It was only after that that I became ill, but never made the connection. The next blood test showed that the kidneys were OK, but I still wonder if it was taking the Bendro.... or the Pravastatin which was at fault. Of course, it might have been neither.