Statins ‘fail to work for half of patients’

HALF of people prescribed statins are left at high risk of heart disease as the pills fail to lower cholesterol, a major study suggests.

Experts last night called for a much more tailored approach to the use of statins in the wake of the ‘alarming’ findings.

The study of 165,400 British people, led by the University of Nottingham, showed 49 per cent of patients given the drugs did not see their cholesterol fall to healthy levels within two years.

Researchers believe this may be down to their genetic make-ups rendering the pills ineffective or it could be that other medications they take interfere with the way statins work. Another theory is that many people in the study might have simply stopped taking their statins.

Roughly six million people in Britain take the cholesterol-busting pills, preventing 80,000 heart attacks and strokes every year at the cost of roughly £20 a year per patient. The drugs are designed to cut levels of ‘bad’ LDL cholesterol in the blood, reducing furring of the arteries and cutting the risk of heart-related problems.

But the new study, which used GP records from patients across the UK, found only half of patients prescribed the medicine saw the response they expected.

The researchers found for 51 per cent of patients statins were incredibly effective – cutting cholesterol by at least 40 per cent within two years. But for the other 49 per cent there was no significant impact. And these patients were 22 per cent more likely to develop cardiovascular disease than those who did.

The researchers admitted the data only showed whether each participant was prescribed statins, not whether they actually took it, so they urged patients not to stop taking their medication until there are more definitive findings. But study leader Dr Stephen Weng said: ‘We have to develop better ways to understand differences between patients and how we can tailor more effective treatment for those millions of patients who are simply blanket prescribed statins.’

Writing in the Heart medical journal, the research team said: ‘Currently, there is no management strategy in clinical practice which takes into account patient variations in [low density cholesterol] response and no guidelines for predictive screening before commencement of statin therapy.’ In a linked editorial in the same journal, Dr Marcio Bittencourt of University Hospital Sao Paolo in Brazil wrote that the number of patients responding poorly was ‘clearly alarming’. He said doctors may be to blame for not giving strong enough doses of the drugs.

He wrote: ‘Both physicians and patients should be targets for approaches aiming at improving adherence.’ But other doctors dismissed the study’s findings. Professor Metin Avkiran of the British Heart Foundation said: ‘Statins are an important and proven treatment for lowering cholesterol and reducing the risk of a potentially fatal heart attack or stroke. Although this study suggests that not everyone who is prescribed statins manages to reduce their cholesterol sufficiently, it doesn’t explain why. If you have been prescribed statins you should continue to take them regularly, as prescribed.’

Professor Kausik Ray of Imperial College London, said: ‘The only conclusion is that a large portion of people do not achieve guideline-based recommendations.

‘I do not agree this is genetic variation and tests are needed.

‘What is needed is for doctors to prescribe the right doses in the first place and for patients to be educated about adherence.’

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, added: ‘We would encourage anyone who is on regular medication to attend their scheduled medication reviews and to raise any queries or concerns.’