Re: Are statins overprescribed? Why the risks and benefits are so complex
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Dec 04, 2018 11:00AM
Thanks for sharing that CNN article Cabel. I heard a similar NPR story on the radio on the drive home yesterday. Both write ups deal with the Annals of Internal Medicine article published yesterday. I haven't had time to dive in to the article, but the CNN/NPR stories seem to sum it up nicely.
You stated "I found this recent article on Statins,... was wondering if they reduce the use of Statins,.. does that open the door to more Abetalone sales (if Phase 3 results are good),...?"
This recent study in mainly dealing with the over prescription of statins as a form of primary cardiovascular prevention. Primary prevention is concerned with preventing the onset of disease before there is evidence of disease. This is in contrast to secondary prevention, which is concerned with preventing the recurrence of the existing disease or preventing more severe problems associated with the exisitng disease from developing. BETonMACE enrolled high-risk patients with diabetes, low-HDL and a prior acute coronary syndrome event. The use of statins and apabetalone in BETonMACE is secondary prevention. Here's the relevant part of the CNN article. I added the bolding and underlining and the [note].
"The main takeaway from the new study and the new cholesterol guidelines is that "the threshold for starting statins in primary prevention is a complex one and must be individualized to the patient," said Dr. Michael Blaha, an associate professor and director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, who was not involved in the study.
"Those guidelines feature a detailed discussion between clinician and patient before ever prescribing a statin. The guidelines recommend a thorough assessment of risk and a careful assessment of patient preferences before initiating what could be lifelong therapy," Blaha said.
"Statins are very safe. For patients with prior heart attacks or strokes, statins lead to overwhelming cardiovascular benefit [my note: this is secondary prevention]. However, in primary prevention, the margin of benefit of these drugs can be small. In lower risk primary prevention patients, statins may not lead to a net benefit," he said. "That is why it is critical to conduct careful risk assessment and consider patient preferences before initiating statin therapy.""