CKD patients might lose out in patented statin ban

Pressure on GPs to prescribe generic statins could be detrimental for the health of patients with chronic kidney disease (CKD), suggest US research findings.

A subanalysis of the Treating to New Targets study focused on 9,656 patients with CHD, 3,107 with an estimated glomerular filtration rate (eGFR) below 60ml/min/1.73m2.

Patients were randomly assigned to atorvastatin 80mg or 10mg daily.

After five years' follow-up, 11.3 per cent of patients with CHD and CKD had a major cardiovascular event, compared with 8.6 per cent of those with CHD alone.

Closer analysis showed that intensive statin therapy with 80mg atorvastatin daily was associated with a 32 per cent reduced relative risk of a major cardiovascular event in CKD patients, compared with those on 10mg daily.

But this effect was less marked in CHD patients with normal eGFR, who had a 15 per cent reduced risk if taking 80mg atorvastatin.

Dr Terry McCormack, Primary Care Cardiovascular Society chairman, said the finding was 'significant'.

He added that it 'does support the use of aggressive lipid lowering in this group of patients'.

'This does support the idea that in certain patients, the lower you go the better,' said Dr McCormack.

Since September 2006, GPs have come under increased pressure from the DoH to switch patients taking patented drugs such as atorvastatin and switch them to generics like simvastatin, which has less efficacy at standard dose.

Treasury minutes from earlier this year indicated that the NHS has already saved £80 million through the initiative.

rachel.liddle@haymarket.com

J Am Coll Cardiol 2008: 51; 1,448-54

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