The Pharmaceutical Journal
Vol 270 No 7252 p784
7 June 2003

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The Lancet (www.thelancet.com)

First trial of statins in renal transplant

The effect of statins on renal transplant patients has been tested for the first time in a prospective controlled trial.

Kidney transplant patients are at increased risk of premature cardiovascular disease. Many have pre-existing conditions at the time of transplantation, with immunosuppressive therapy aggravating existing risk factors or promoting new ones, notably high cholesterol and high blood pressure.

The new study looked at the effect of fluvastatin versus placebo in 2,102 renal transplant patients with total cholesterol 4.0–9.0mmol/L. After a mean follow up of 5.1 years, fluvastatin lowered LDL cholesterol concentrations by 32 per cent. There were fewer cardiac deaths and non-fatal myocardial infarctions in the fluvastatin group (70 compared with 104 in the placebo group, risk ratio 0.65). However, risk of the primary endpoint, "the occurrence of a major adverse cardiac event, defined as cardiac death, non fatal MI or coronary intervention procedure", was not reduced significantly.

Reporting the results on The Lancet's website (www.thelancet.com), the authors commented that as many as 50 per cent of renal transplant patients are now treated with statins. These agents had previously been found effective in patients with mild renal failure who were at increased cardiovascular risk. This study showed similar benefits for fluvastatin in patients "at the opposite end of the spectrum of renal failure", they say.