Statin guidelines should give best statin

doi:10.1136/bmj.333.7557.46

BMJ 2006;333:46 (1 July), doi:10.1136/bmj.333.7557.46

Letter

Statin guidelines should give best statin

The first 150 words of the full text of this article appear below.

EDITOR—Manuel et al show that guidelines on statin treatmentshould focus on people with the highest risk of coronary heartdisease.¹ However, concerns about the optimal choice of statinsremain.

A recent meta-analysis (n = 71 108) of randomised controlledtrials has shown that the occurrence of myalgia is less commonwith fluvastatin, pravastatin, and simvastatin than atorvastatin(odds ratio 0.28, 95% confidence interval 0.18 to 0.44; 0.43,0.36 to 0.51; 0.23, 0.19 to 0.28; respectively).² This observationcould also be supported by Japanese postmarketing surveys forboth atorvastatin and pitavastatin.^{3 4} For example, atorvastatinhad an increased risk of musculoskeletal adverse events includingthe elevations of serum creatine phosphokinase as an importantindicator of rhabdomyolysis compared with pitavastatin in Japanesecommon clinical practice (atorvastatin 144/4805, pitavastatin154/7930; risk ratio 1.54, confidence interval 1.23 to 1.93;P = 0.0001 by using the Mann-Whitney U test).^{3 4} This differencewas shown . . . [Full text of this article]

Hisashi Moriguchi, professor

Laboratory for Systems Biology and Medicine, RCAST, University of Tokyo, 4-6-1, Komaba, Meguro-ku, Tokyo, Japan 153-8904 moriguchi@lsbm.org

Takamoto Uemura, assistant professor

Kyorin University, Tokyo

Chifumi Sato, professor

Tokyo Medical and Dental University, Tokyo

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Effectiveness and efficiency of different guidelines on statin treatment for preventing deaths from coronary heart disease: modelling study: Douglas G Manuel, Kelvin Kwong, Peter Tanuseputro, Jenny Lim, Cameron A Mustard, Geoffrey M Anderson, Sten Ardal, David A Alter, and Andreas Laupacis
BMJ 2006 332: 1419. [Abstract] [Full Text] [PDF]