The American Heart Journal has published a meta analysis of statin trials involving simvastatin, pravastatin and atorvastatin.
The review includes 8 trials involving over 63,000 patients. All trials had a similar lipid reducing effect and statistical analysis showed minimal heterogeneity between the effect sizes.
Overall, there was no difference between the three statins in reduction of fatal coronary heart disease and nonfatal myocardial infarctions. Similarly, there were no detectable differences in fatal and nonfatal strokes, all cardiovascular deaths, and all-cause mortality.
Peas in a pod!
Hat tip: Prescribing advice for GPs
9 comments:
Why is AHA allowed to a meta-analysis and it's credible but when industry does it, it's deemed unscientific?
As Frankie said: "That's life"!
I'll tell you why it's deemed unscientific if you can find me an industry sponsored meta-analysis that DIDN'T find in favour of the sponsors drug!
It is endothelial stabilization that saves lives. Save the Crestor and Lipitor for those few patients that can't reach goal LDL. The Crestor reps are on a holy war now that Zocor is going generic.
---Pharm.Demon
Any chance of giving us the paper info as the link only gives me an error?
Is it this paper?
The American Journal of Cardiology, Volume 97, Issue 8, Supplement 1, 17 April 2006, Pages S95-S97, John R. Guyton
Ta Muchly
Benedict
So anti-industry!! What if it had recently been revealed that 65% of psychiatrists associated with the DSM-IV had received funding from NIH or had all gone to the same school - would your skeptical reaction be the same? Be a little more balanced and critical in your thinking. The backlash against industry will eventually turn, and you'll be stuck with your extremist views.
Try this:
http://tinyurl.com/mthlp
Regards
Insider
Are statins created equal? Evidence from randomized trials of pravastatin, simvastatin, and atorvastatin for cardiovascular disease prevention
Zheng Zhou MD, PhDa, b, Elham Rahme PhDa, b and Louise Pilote MD, MPH, PhDa, b, ,
aDepartment of Epidemiology and Biostatistics, McGill University, Montréal, Quebec, Canada
bDivision of Clinical Epidemiology, Montréal General Hospital, Montréal, Quebec, Canada
Received 1 November 2004; accepted 1 April 2005. Available online 25 January 2006.
Background
The relative efficacy of different statins for long-term cardiovascular prevention remains largely undetermined.
Methods
Using adjusted indirect comparison, we compared 3 statins (pravastatin, simvastatin, and atorvastatin) based on published randomized placebo-controlled trials for long-term cardiovascular prevention. A systematic literature search between 1980 and 2004 was conducted. Randomized placebo-controlled trials of the 3 statins, which studied cardiovascular diseases or death as the outcome, enrolled ≥1000 participants, and had ≥1-year follow-up, were included. Trials were grouped according to the statin under study. A pooled relative risk (RR) was derived from each set of trials using a random-effects model. Adjusted indirect comparisons using pooled RRs were made between statins with regard to prespecified clinical outcomes.
Results
Eight placebo-controlled trials met the inclusion criteria, including 4 pravastatin trials (n = 25 572), 2 simvastatin trials (n = 24 980), and 2 atorvastatin trials (n = 13 143). All trials had a similar degree of lipid reduction. Graphical and statistical assessments showed minimal heterogeneity in the trials' effect sizes. Adjusted indirect comparisons did not reveal a statistically significant difference between statins in reducing fatal coronary heart disease and nonfatal myocardial infarctions (simvastatin vs pravastatin: RR 0.93 [95% CI 0.84-1.03]; atorvastatin vs simvastatin: RR 0.84 [95% CI 0.66-1.08]; atorvastatin vs pravastatin: RR 0.79 [95% CI 0.61-1.02]). We were unable to detect differences either in outcomes for fatal and nonfatal strokes, all cardiovascular deaths, and all-cause mortality.
Conclusion
Evidence from published statin randomized placebo-controlled trials suggests that pravastatin, simvastatin, and atorvastatin, when used at their standard dosages, show no statistically significant difference in their effect on long-term cardiovascular prevention.
I promise, I don't sell it, but I take it, Crestor (rosuvastatin) hands down is stronger than other statins. I've heard Vytorin is as good too.
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