NICE could review statins policy following new trial findings

Jack Woodfield
Thu, 06 Sep 2018
NICE could review statins policy following new trial findings
Statins are not effective in reducing the risk of heart attacks or stroke in older people without diabetes, but afford some protection to those with diabetes aged 75-84, research suggests.

The National Institute for Health and Care Excellence (NICE) reportedly now plans to review its prevention advice regarding statins.

Statins are cholesterol-lowering drugs that are prescribed to reduce the risk of cardiovascular problems. However, a number of studies have shown the drugs only work in a small number of people and have been associated with the development of type 2 diabetes.

Under current NICE guidelines, GPs are advised to consider prescribing statins to people aged 85 or older who face an increased risk of cardiovascular disease (CVD). According to The BMJ, nearly 12 million people in England would be taking statins if GPs followed these guidelines last year.

These new findings, reported by scientists at the University of Girona in Spain, call into question the current NICE guidelines as the benefits of statins were only confined to a certain group of people.

A total of 46,864 people aged 75 years or older, including users and non-users of statins, without atherosclerosis (a cardiovascular condition) were reviewed between 2006-2015.

Statin treatment was not associated with a reduced risk of cardiovascular events in healthy people over 75 years old, and no benefit was seen in people with type 2 diabetes aged 85 years or older.

However, in people with type 2 diabetes aged 75-84, statins were linked to a reduced incidence of atherosclerosis by 24% and all-cause mortality by 16%.

"These results do not support the widespread use of statins in old and very old populations, but they do support statin treatment in selected people such as those aged 75-84 years with type 2 diabetes," said the authors.

In an interview with Pulse, NICE director for guidelines Professor Mark Baker revealed that NICE now plans to review its advice on statins. He said: "There is a growing body of evidence in this area which we acknowledge needs to be looked at in an update of our cardiovascular disease: risk assessment and reduction, including lipid modification' guideline and preparations are being made to do this. This BMJ study will form part of that update."

There is now a focus on avoiding overtreating the elderly, with next month's National Conference of the Older People's Diabetes Network (OPDN) set to discuss this.

The findings of the study have been published in The BMJ.
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