Statins have a class effect in terms of their action on lipids, an International
Task Force for Prevention of Coronary Heart Disease concluded at a “consensus
on statins” meeting in Paris, on September 9.
Summarising the group’s consensus, Professor Gerd Assmann (Institute of
Arteriosclerosis Research, University of Münster, Germany) said that all
statins had the same effect on lipids.
Statins all lowered low density lipoprotein (LDL) cholesterol and triglycerides
and increased high density lipoprotein (HDL) cholesterol and, in addition, they
all had a good safety and tolerability profile. However, there were differences
in the pharmacokinetics of the drugs and in their effects other than that of
lowering lipids (see p465).
The group concluded that the target LDL level should be 2.6mmol/L. Professor
Assman said that lowering LDL to this level was “undoubtedly safe”.
Professor David Galton (professor of diabetes and lipids, St Bartholomew’s
hospital, London) told The Journal on September 15 that the consensus was similar
to current national guidelines.
The recent National Services Framework on coronary heart disease (PJ, March
11, p396) recommends
that statins should be given to reduce LDL to below 3mmol/L or by 30 per cent,
whichever is the greater. Professor Galton said that he was using a target LDL
level of 3mmol/L for most patients but in patients with heart disease he tried
to lower LDL levels further. He did not think that the consensus would have
an impact on prescribing habits in the UK because all the statins were already
used. (At the meeting it was mentioned that in some countries in Europe, statin
prescribing was limited to one or two drugs.)
The task force also agreed that further information was needed about the use
of statins in currently under-treated groups, such as the elderly, women and
patients with diabetes.
Information about the consensus meeting can be found on the Task Force’s
website (www.chd-taskforce.com)
from September 25.