Treat to target benefits no one

doi:10.1136/bmj.39493.435556.1F

BMJ 2008;336:406 (23 February), doi:10.1136/bmj.39493.435556.1F

Letters

Strategies for statins

Treat to target benefits no one

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

Donner-Banzhoff and Sönnichsen highlight the lack of evidencefor "treating to target" with statins.¹ Treatment targets canlead to an escalation of treatment that is not evidence based,drain clinical resources through repeat clinic visits and bloodtests, and can lead to the unnecessary use of branded statins,which bring no additional benefit to the patient and are atleast 13 times more expensive than generic statins.²

However, Donner-Banzhoff and Sönnichsen have oversimplifiedthe Scottish Intercollegiate Guidelines Network (SIGN) adviceon statins. The SIGN guideline differs from other guidance inthe United Kingdom: it does not recommend treatment targetsfor statins in primary prevention of cardiovascular disease.³It uses the findings of Hayward’s exploration of statintreatment targets⁴ to note that current clinical evidence doesnot show that lipid treatment should be titrated to achieveproposed low density lipoprotein (LDL) cholesterol targets.The only treatment target mentioned in the SIGN . . . [Full text of this article]