Are Statins the Wonder Drug They Appear to Be?

The Herald | 01.12.2009

A Dutch study has found that treatment with a cholesterol-lowering statin drug reduces new cases of Alzheimer's disease. It's the latest news about what seems to be one of the pharmaceutical success stories of recent years.

What are statins?

They are drugs that lower the risk of heart attacks and strokes by reducing levels of harmful cholesterol in the blood, are used by millions and are considered to be very safe.

What are they good for?

They are most famed for helping to prevent heart attacks and stroke. Last year, one of the largest trials of a statin was wrapped up early after dramatic reductions in illness and mortality were seen in treated patients. Statins are currently offered only to people with a moderate-to-high risk of a cardiovascular "event", but in this trial, even people who were not in a risky category were found to suffer far fewer adverse heart events than those given a placebo. Doctors said the study might lead millions more people across the world to consider taking the drug. It was stopped six months early by independent safety monitors because the benefits were so pronounced that it was considered unethical to keep giving some patients a placebo.

And they can help prevent Alzheimer's, too?

It appears so. There have been several studies about statin use and the development of Alzheimer's, but with conflicting results. One explanation for the inconsistencies is that only the fat-soluble or lipophilic statins, which could get into the brain more easily than water-soluble or hydrophilic statins, were included in the studies. The latest Dutch study teased out these issues by testing both types of statin. It found that using the drugs reduced new cases of Alzheimer's regardless of the specific type of statin used, or indeed a person's genetic risk of developing the disease.

People with diabetes appear also to benefit from taking the drug: a study involving nearly 90,000 participants found that a wide range of patients benefited from the treatment, irrespective of what kind of diabetes they had.

It does sound like a wonder drug. Are there any downsides?

Some people report side effects such as lethargy and aching muscles. Another study published this week found that statins may very occasionally cause double vision, eyelid droop or weakness of the muscles that control eye movement, but serious side effects are rare.

Another potential complication of taking the drug, reported in an international cancer journal last year, was that statins may cause some prostate cancers to be missed by doctors. That's because men taking statins experienced a significant drop in blood levels of a prostate cancer biomarker. The danger is that this could lead to misleading results from prostate specific antigen (PSA) tests carried out as part of cancer screening.

Some studies have suggested that statins may protect against prostate cancer or slow progression of the disease. However, just because statins lower PSA does not necessarily mean they have a biological effect on prostate cancer.

Copyright The Herald 2009