Statins Usually Well Tolerated, With Few Adverse Effects
Simvastatin and pravastatin appear safer and more tolerable compared to other statins
TUESDAY, July 9 (HealthDay News) -- Adverse events from statin therapy are not common, according to a review published online July 9 in Circulation: Cardiovascular Quality and Outcomes.
Huseyin Naci, M.H.S., from the London School of Economics and Political Science, and colleagues systematically reviewed randomized trials evaluating different statins in participants both with and without cardiovascular disease. The relative harms of individual statins were quantified using random-effects pairwise and network meta-analyses.
Based on 55 two-armed placebo-controlled and 80 two- or multi-armed active-comparator trials involving 246,955 individuals, the researchers found that individual statins were no different than control with regard to discontinuations due to adverse events, myalgia, creatine kinase (CK) elevation, and cancer. There were significantly higher odds of diabetes (odds ratio [OR], 1.09) and transaminase elevations (OR, 1.51) with statins as a class, compared to control. There were numerous statistically detectable differences, favoring simvastatin and pravastatin in network meta-analyses. Atorvastatin and rosuvastatin resulted in higher odds of discontinuations with higher doses. There were higher odds of transaminase elevations with higher doses of atorvasatin, fluvastatin, lovastatin, and simvastatin. CK elevations (OR, 4.14) were found to be associated with the highest doses of simvastatin. Adjustments for study-level age at baseline, low-density lipoprotein cholesterol level, and publication year did not explain heterogeneity.
"As a class, adverse events associated with statin therapy are not common," the authors write.