Prescribing: GPs divided over statins for healthy patients
By Sanjay Tanday, 13 March 2009
Poll finds that almost half of doctors accept evidence that statins can benefit healthy patients.
Doctors are split over the benefits of offering statins to healthy people, according to an international survey.
The results come as the DoH considers increasing the number of people who receive the drugs for the prevention of cardiovascular disease (GP, 6 March).
England's national director for heart disease and stroke Professor Roger Boyle has said NICE will review whether more patients should receive them.
The online poll of 2,553 readers by the New England Journal of Medicine (NEJM) found 48 per cent believe the therapeutic use of statins in healthy people should be changed based on results of the JUPITER trial.
The JUPITER trial, published in November last year, showed statins can cut major cardiovascular events among healthy people with a risk of 10-20 per cent.
The study involved 17,802 healthy men and women who were randomly assigned to receive rosuvastatin 20mg or placebo daily.
Overall, the researchers found rosuvastatin cut heart attack risk by 54 per cent in people with normal cholesterol levels and total mortality by 44 per cent.
The findings were so strong that the study was halted after just 1.9 years instead of the full five years once it became clear that participants given the placebo had an increased risk of CVD events and death.
In light of the results, the NEJM poll also found that 49 per cent of doctors believe the approach to screening healthy patients to identify those who could benefit from statins should change.
A total of 473 respondents, of whom 85 per cent were practising physicians, posted additional comments online.
Many of these stated that the results of JUPITER added to the growing body of literature on the therapeutic benefit of statins.
However, concerns were also raised about the trial's findings, including the large number of patients who need to be treated to prevent one clinical event, the cost of the medicines, the underlying health of the patients and the early termination of the study.
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