Comparative Tolerability and Harms of Individual Statins: A Study-Level Network Meta-Analysis of 246 955 Participants From 135 Randomized, Controlled Trials

@article{Naci2013ComparativeTA,
  title={Comparative Tolerability and Harms of Individual Statins: A Study-Level Network Meta-Analysis of 246 955 Participants From 135 Randomized, Controlled Trials},
  author={Huseyin Naci and Jasper J. Brugts and Tony Ades},
  journal={Circulation: Cardiovascular Quality and Outcomes},
  year={2013},
  volume={6},
  pages={390–399}
}
Background—Our objective was to estimate the comparative harms of individual statins using both placebo-controlled and active-comparator trials. Methods and Results—We systematically reviewed randomized trials evaluating different statins in participants with and without cardiovascular disease. We performed random-effects pairwise and network meta-analyses to quantify the relative harms of individual statins. We included 55 two-armed placebo-controlled and 80 two- or multiarmed active… 

Figures and Tables from this paper

Associations between statins and adverse events in primary prevention of cardiovascular disease: systematic review with pairwise, network, and dose-response meta-analyses
TLDR
The risk of adverse events attributable to statins was low and did not outweigh their efficacy in preventing cardiovascular disease, suggesting that the benefit-to-harm balance of statins is generally favourable.
Industry sponsorship bias in research findings: a network meta-analysis of LDL cholesterol reduction in randomised trials of statins
TLDR
The analysis shows that the findings obtained from industry sponsored statin trials seem similar in magnitude as those in non-industry sources, and there are actual differences in the effectiveness of individual statins at various doses that explain previously observed discrepancies between industry and non- industry sponsored trials.
Comparative Lipid-Lowering/Increasing Efficacy of 7 Statins in Patients with Dyslipidemia, Cardiovascular Diseases, or Diabetes Mellitus: Systematic Review and Network Meta-Analyses of 50 Randomized Controlled Trials
TLDR
According to the NMAs, it can be concluded that rosuvastatin ranked 1st in LDL-C, ApoB-lowering efficacy and ApoA1-increasing efficacy, which can provide references and evidence-based foundation for drug selection in both statin monotherapies and statin combination therapies.
Intensity of statin therapy and muscle symptoms: a network meta-analysis of 153 000 patients
TLDR
For approximately each 200 patients on high intensity statins, one additional patient may experience myalgia or discontinue therapy due to muscle problems compared with moderate intensity therapy, and estimates were inconclusive for rhabdomyolysis and CK.
Do Statins Impair Cognition? A Systematic Review and Meta-Analysis of Randomized Controlled Trials
TLDR
Statin therapy was not associated with cognitive impairment in RCTs, and this results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.
Statins Cardiovascular Benefits Outweigh their Diabetogenicity: A Direct Comparison between Number Needed to Treat and Number Needed to Harm
TLDR
The results suggest that the absolute risk of NODM by statin is offset by the benefit for reducing cardiovascular events, which could resolve the limitations of previous studies and provide further reinforced evidence that the merit of statin use for the purpose of lowdensity lipoprotein cholesterol lowering outweighs the NodM risk.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 149 REFERENCES
Dose-comparative effects of different statins on serum lipid levels: a network meta-analysis of 256,827 individuals in 181 randomized controlled trials
TLDR
Supporting evidence is provided for the dose–response relationship of statins in reducing LDL and total cholesterol and the LDL cholesterol-reducing effects of some statins appear less pronounced than the findings of previous meta-analyses.
Comparative effects of statins on major cerebrovascular events: a multiple-treatments meta-analysis of placebo-controlled and active-comparator trials.
TLDR
Across all populations, statins were significantly more effective than control in reducing major cerebrovascular events [odds ratio]: 0.82, 95% CI: 0.77, 0.87], with no differences among individual statins.
Adverse events associated with individual statin treatments for cardiovascular disease: an indirect comparison meta-analysis.
TLDR
A meta-analysis and indirect comparisons employed to identify differing risk effects across statins found that atorvastatin significantly elevated AST levels compared to pravastatin and simvASTatin significantly increased CK levels when compared to rosuvastsatin.
Risks Associated with Statin Therapy: A Systematic Overview of Randomized Clinical Trials: P113
Background— Although statins reduce the risk of cardiovascular events, concerns about adverse effects may deter physicians from prescribing these agents. We performed a systematic overview of
Comparative benefits of statins in the primary and secondary prevention of major coronary events and all-cause mortality: a network meta-analysis of placebo-controlled and active-comparator trials
TLDR
Statins significantly reduce the incidence of all-cause mortality and major coronary events as compared to control in both secondary and primary prevention and had the highest overall probability of being the best treatment in terms of both outcomes.
The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials
TLDR
In patients without established cardiovascular disease but with cardiovascular risk factors, statin use was associated with significantly improved survival and large reductions in the risk of major cardiovascular events.
...
1
2
3
4
5
...