Long-term efficacy and safety of statin treatment beyond six years: A meta-analysis of randomized controlled trials with extended follow-up

• Published in: Pharmacological research 2014-03, Vol.81, p.64-73
• Main Authors: Lv, Han-lu, Jin, Dong-mei, Liu, Mo, Liu, Ying-mei, Wang, Jing-feng, Geng, Deng-feng
• Format: Article
• Language: English
• Subjects: Cancer; Cardiovascular Diseases - epidemiology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - drug therapy; Hypercholesterolemia - epidemiology; Incidence; Meta-analysis; Mortality; Neoplasms - epidemiology; Randomized Controlled Trials as Topic; Safety; Statin; Treatment Outcome
• ISSN: 1043-6618; 1096-1186
• DOI: 10.1016/j.phrs.2014.02.006

[Display omitted] Large-scale randomized controlled trials (RCTs) have well demonstrated the beneficial effects of cholesterol-lowering treatment with statins in patients at high risk of vascular disease. However, large statin RCTs were usually restricted to the typical 5–6 years. Moreover, non-cardiovascular events, especially the risk of cancer, probably failed to emerge within a restricted period of 6 years. The aim of this study was to evaluate the long-term efficacy and safety of statin treatment by performing a meta-analysis of statin RCTs with extended follow-up beyond 6 years. Six RCTs with post-trial follow-up were eligible for inclusion, involving 47,296 patients with total follow-up ranging from 6.7 to 14.7 years. During the post-trial period, all the surviving participants were advised to take a statin and the cholesterol level were almost identical between the original statin group and the original placebo group. Over the entire 6.7–14.7 years of follow-up, a significant reduction in the rates of all-cause mortality (relative risk 0.90, 95% confidence interval 0.85–0.96; P=0.0009), cardiovascular mortality (0.87, 0.81–0.93; P