Statins: The Next Miracle Drugs?

Besides cutting cholesterol, they may fight breast cancer, even arthritis

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By
HealthDay Reporter

TUESDAY, July 27, 2004 (HealthDayNews) -- If you've been paying any attention to medical news in the last few years, you've almost certainly heard the word "statins."

You may even have heard this question: "Could statins be the next miracle drug?"

Statins, the marketing term for a group of drugs called HMG-CoA reductase inhibitors -- named for the enzyme whose activity they block -- are most commonly prescribed for their ability to lower levels of LDL cholesterol, the "bad" kind that clogs arteries.

They are extremely effective at this task. Studies have shown that statin therapy can cut a person's LDL levels in blood by between by 25 percent to 35 percent. That translates into a significantly lower risk of heart attack and stroke.

Statins also appear to raise levels of HDL, the "good" cholesterol, too, which further reduces the risk of cardiovascular trouble. And they help the heart and vessels in other ways -- by preventing the breakaway of clot-forming deposits, or plaques, that line diseased arteries, and by relaxing blood vessels, spurring the formation of new vessels and preventing blood clots.

Evidence also indicates that higher doses of statins continue to bring down LDL, which doctors are increasingly coming to recognize as "the lower the better" marker of heart disease risk.

The strength of their cholesterol-busting properties has propelled statins to blockbuster status. In 2000, they were already the world's number two class of prescription drugs, with sales of $15.9 billion, according to IMS Health, a market research group.

And use of statins is expected to increase. U.S. health officials earlier this month issued new guidelines for heart patients to lower their LDL levels to 70, from the previously recommended level of 100.

Still, statins are still considered to be widely under-prescribed, at least for cholesterol.

Roughly 11 million Americans are getting the drugs, while an estimated 36 million should be on them, experts say. More than 200 million people worldwide meet the criteria for statin treatment, yet only 25 million are using the drugs.

Research is showing that statins have beneficial attributes for other health problems, including breast cancer, stroke, bone strength and rheumatoid arthritis.

  • Breast cancer. A study published in the online edition of Cancer in April found that postmenopausal women who used statins for more than five years had a lower risk of breast cancer. Denise M. Boudreau, lead author of the study, which was her Ph.D. dissertation project at Fred Hutchinson Cancer Center in Seattle, said the study added more information to what earlier research had indicated. "I believe we can be confident about what's going on. It's too early to draw a conclusion, but I think they're encouraging results and reassuring, and they are supported by laboratory data that show that statins do, through a variety of mechanisms, decrease cancer risk," she said.
  • Stroke. People who have an ischemic stroke while they're taking statins seem to have better outcomes than stroke survivors who weren't taking statins at the time of their stroke. That's the finding of a study published in April in Stroke: Journal of the American Heart Association. Ischemic strokes are caused by a blood clot that blocks blood flow to the brain.
  • Bone strength. The data from four large studies reviewed in a January 2004 issue of the Archives of Internal Medicine suggested that people taking statins had a 38 percent to 81 percent lower risk of hip fractures and a 5 percent to 51 percent lower risk of non-spine fractures.
  • Rheumatoid arthritis. In the first study of its kind, presented last fall at the American College of Rheumatology's annual scientific meeting in Orlando, Fla., researchers found statins eased some of the inflammation that is a characteristic of rheumatoid arthritis, while reducing cholesterol levels and other risk factors for cardiovascular disease. "This is very important and potentially a turning point in the way in which we think about treating rheumatoid arthritis," said Dr. John Klippel, president and chief executive officer of the Arthritis Foundation.

As encouraging as the research is, statins aren't ready to be added to drinking water. They can cause potentially serious side effects, including a muscle destroying disease called rhabdomyolysis that can be crippling and even deadly if not caught early. Bayer pulled its entry in the statin stakes, in August 2001, after 31 people died of rhabdomyolysis linked to the medication.

Statins also have been known to cause muscle pain and weakness, fatigue, memory and cognitive problems and sleep disturbances. And the drugs may lead to erectile dysfunction and sweats and other trouble regulating body temperature.

And in April, researchers from the U.S. National Institutes of Health reported that statin use by women during the first trimester of pregnancy may increase the chances that their babies will be born with severe central nervous system defects and limb deformities.

More information

To learn more about statins, visit the National Heart, Lung, and Blood Institute.

SOURCES: Denise M. Boudreau, Ph.D., research associate, Center for Health Studies, Group Health Cooperative, Seattle; April 8, 2004, news release, American Heart Association; Jan. 26, 2004, Archives of Internal Medicine; John Klippel, M.D., president and chief executive officer, Arthritis Foundation, Atlanta; Oct. 23-28, 2003, presentations, American College of Rheumatology annual scientific meeting, Orlando, Fla.; Maximilian Muenke, M.D., chief, medical genetics branch, National Human Genome Research Institute, Bethesda, Md.

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