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Combination therapy versus intensification of statin monotherapy: an update Combination therapy versus intensification of statin monotherapy: an update Combination therapy versus intensification of statin monotherapy: an update Monroe AK, Gudzune KA, Sharma R, Chelladurai Y, Ranasinghe PD, Ansari MT, Robinson KA Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made (...) for the HTA database. Citation Monroe AK, Gudzune KA, Sharma R, Chelladurai Y, Ranasinghe PD, Ansari MT, Robinson KA. Combination therapy versus intensification of statin monotherapy: an update. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 132. 2014 Authors' objectives To assess the benefits and harms of combination of statin and other lipid-modifying medication compared to intensification of statin monotherapy. This is an update to a 2009 review
HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cardiovascular disease (CVD) is the most frequent cause of death in people with early stages of chronic kidney disease (CKD), for whom the absolute risk of cardiovascular events is similar to people who have existing coronary artery disease. This is an update of a review published in 2009, and includes evidence from 27 new studies (25,068 participants) in addition to the 26 studies (20,324 (...) participants) assessed previously; and excludes three previously included studies (107 participants). This updated review includes 50 studies (45,285 participants); of these 38 (37,274 participants) were meta-analysed.To evaluate the benefits (such as reductions in all-cause and cardiovascular mortality, major cardiovascular events, MI and stroke; and slow progression of CKD to end-stage kidney disease (ESKD)) and harms (muscle and liver dysfunction, withdrawal, and cancer) of statins compared with placebo
Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases. To evaluate the incremental increase in new onset diabetes from higher potency statins compared with lower potency statins when used for secondary prevention.Eight population based cohort studies and a meta-analysis.Six Canadian provinces and two international databases from the UK and US.136,966 patients aged ≥ 40 years newly treated with statins between 1 January 1997 and 31 (...) March 2011.Within each cohort of patients newly prescribed a statin after hospitalisation for a major cardiovascular event or procedure, we performed as-treated, nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Rate ratios of new diabetes events were estimated using conditional logistic regression on different lengths of exposure to higher potency versus lower potency statins; adjustment for confounding
Statin Strikeout. 24835850 2014 06 10 2018 12 02 1533-4406 370 23 2014 Jun 05 The New England journal of medicine N. Engl. J. Med. Statin strikeout. 2240-1 10.1056/NEJMe1405032 Drazen Jeffrey M JM From the Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York (A.C.G.). Gelijns Annetine C AC eng Editorial Comment 2014 05 18 United States N Engl J Med 0255562 0028-4793 0 Fluorobenzenes 0 Hydroxymethylglutaryl-CoA Reductase Inhibitors 0 Pyrimidines 0
New Cholesterol Guidelines: How Safe Are High-Potency Statins? New Cholesterol Guidelines: How Safe Are High-Potency Statins? – Clinical Correlations Search New Cholesterol Guidelines: How Safe Are High-Potency Statins? May 14, 2014 9 min read By Molly Anderson Peer Reviewed Managing hyperlipidemia is a mainstay of cardiovascular risk reduction. The 2013 ACC/AHA guidelines no longer target specific low-density lipoprotein (LDL)-cholesterol levels, . Adoption of the new guidelines would (...) result in millions more Americans receiving high-potency statins; it is therefore important to investigate potential dangers associated with aggressive therapy and the long-term implications for patients. Many studies have shown that strict adherence to [2-5]. The Adult Treatment Panel III guidelines (2002), still used by many physicians, recommended intensive therapy for those in the “very high risk” category: those with known coronary artery disease plus diabetes, tobacco use, or the metabolic
Effectiveness of combination therapy with statin and another lipid-modifying agent compared with intensified statin monotherapy: a systematic review. Some patients do not tolerate or respond to high-intensity statin monotherapy. Lower-intensity statin combined with nonstatin medication may be an alternative, but the benefits and risks compared with those of higher-intensity statin monotherapy are unclear.To compare the clinical benefits, adherence, and harms of lower-intensity statin (...) combination therapy with those of higher-intensity statin monotherapy among adults at high risk for atherosclerotic cardiovascular disease (ASCVD).MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials from inception to July 2013, with an updated MEDLINE search through November 2013.Randomized, controlled trials published in English.Two reviewers extracted information on study design, population characteristics, interventions, and outcomes (deaths, ASCVD events, low-density lipoprotein
Effect of 24 Weeks of Statin Therapy on Systemic and Vascular Inflammation in HIV-Infected Subjects Receiving Antiretroviral Therapy Human immunodeficiency virus (HIV)-infected individuals are at increased risk of cardiovascular disease (CVD) due in part to inflammation. Statins decrease inflammation in the general population, but their effect during HIV infection is largely unknown.This is an ongoing randomized, double-blinded, placebo-controlled trial to evaluate the effect of statin therapy (...) in the statin group, compared with an increase in the placebo group (-28% vs +3.8%; P < .01). A 10% reduction in the lipoprotein-associated phospholipase A2 (Lp-PLA2) level was seen in the statin group, compared with a 2% reduction in the placebo group (P < .01). In multivariable regression, receipt of statin treatment and having a nadir CD4(+) T-cell count of ≤100 cell/µL were the only statistically significant predictors of a decrease in Lp-PLA2 level. Markers of systemic inflammation did not change
Statins may have fewer side effects than is claimed, meta-analysis finds. 24633266 2015 04 06 2018 12 02 1756-1833 348 2014 Mar 14 BMJ (Clinical research ed.) BMJ Statins may have fewer side effects than is claimed, meta-analysis finds. g2151 10.1136/bmj.g2151 bmj.g2151 Wise Jacqui J London. eng News Comment 2014 03 14 England BMJ 8900488 0959-8138 0 Hydroxymethylglutaryl-CoA Reductase Inhibitors AIM IM Eur J Prev Cardiol. 2014 Apr;21(4):464-74 24623264 Humans Hydroxymethylglutaryl-CoA
Statins have no side effects? What our study really found, its fixable flaws, and why trials transparency matters (again). Statins have no side effects? What our study really found, its fixable flaws, and why trials transparency matters (again). – Bad Science Search TED Talk Collected Journalism This Nerdy Book This Great Book T-shirts Categories (3) (4) (6) (45) (28) (6) (16) (190) (5) (20) (52) (88) (2) (1) (2) (1) (677) (4) (14) (2) (37) (4) (9) (3) (11) (6) (3) (16) (13) (1) (6) (8) (6) (6 (...) ) (12) (1) (59) (2) (6) (34) (26) (1) (1) (1) (2) (2) (1) (52) (7) (2) (1) (2) (3) (1) (1) (1) (4) (2) (82) (1) (10) (6) (3) (2) (1) (5) (1) (10) (1) (2) (1) (1) (6) (4) (3) (2) (52) (3) (18) (10) (1) March 13th, 2014 by Ben Goldacre in , , | Hi there, sorry to be absent (dayjob!). I was surprised to see a study I’m a co-author on getting some today, under the headline “Statins ‘have no side effects'”. That’s not what found. But it was an interesting piece of work, with an odd result, looking
Effectiveness of combination therapy with statin and another lipid-modifying agent compared with intensified statin monotherapy: a systematic review Effectiveness of combination therapy with statin and another lipid-modifying agent compared with intensified statin monotherapy: a systematic review Effectiveness of combination therapy with statin and another lipid-modifying agent compared with intensified statin monotherapy: a systematic review Gudzune KA, Monroe AK, Sharma R, Ranasinghe PD (...) , Chelladurai Y, Robinson KA CRD summary The authors concluded that lower-intensity statins combined with bile acid sequestrant or ezetimibe may be an alternative to higher-intensity statin monotherapy for high-risk statin-intolerant patients or those with a low response to statins; a cautious approach in practice was recommended. The authors' conclusion reflected the evidence presented and is likely to be reliable. Authors' objectives To evaluate the effectiveness of lower intensity statin combination
HMG CoA reductase inhibitors (statins) for kidney transplant recipients. People with chronic kidney disease (CKD) have higher risks of cardiovascular disease compared to the general population. Specifically, cardiovascular deaths account most deaths in kidney transplant recipients. Statins are a potentially beneficial intervention for kidney transplant patients given their established benefits in patients at risk of cardiovascular disease in the general population. This is an update of a review (...) first published in 2009.We aimed to evaluate the benefits (reductions in all-cause and cardiovascular mortality, major cardiovascular events, myocardial infarction and stroke, and progression of CKD to requiring dialysis) and harms (muscle or liver dysfunction, withdrawal, cancer) of statins compared to placebo, no treatment, standard care, or another statin in adults with CKD who have a functioning kidney transplant.We searched the Cochrane Renal Group's Specialised Register to 29 February 2012
IMPROVE-IT - To add, or not to add ezetimibe EZETROL to moderate dose statin? RxFiles: Trial Summary www.RxFiles.ca - Dec 2014, Updated June 2015 Loren Regier BSP BA, Brent Jensen BSP IMPROVE-IT To add, or not to add ezetimibe EZETROL to moderate dose statin? What we already knew? ? Statins… have consistently demonstrated efficacy in lowering not only LDL, but risk of cardiovascular (CV) events +/- mortality in those with high CV risk. 1 ? Ezetimibe… 2 o has no evidence as monotherapy (...) for lowering CV/mortality risk o has had very limited, disappointing surrogate outcome evidence, e.g. no ? in intima -media thickness ENHANCE o failed to lower CV/mortality risk in combination with a statin when compared to a placebo in mild - to -moderate, asymptomatic aortic stenosis patients SEAS o when combined with a proven statin therapy (e.g. simvastatin 20mg daily) in chronic kidney disease & dialysis patients (stage 3 -4 CKD patients), was associated with a benefit. However, given the placebo
Statins USE OF STATINS IN PREGNANCY 0344 892 0909 USE OF STATINS IN PREGNANCY (Date of issue: March 2017 , Version: 2 ) This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a . Please encourage all women to complete an . Summary Statins (atorvastatin, fluvastatin, pravastatin, rosuvastatin and simvastatin) are a class of HMG-CoA reductase inhibitors used to lower (...) cholesterol. They act by inhibiting the conversion of HMG-CoA to mevalonate which is a rate-limiting step in the production of cholesterol in the liver. Statins may be indicated, as an adjunct to diet, for the treatment of primary hypercholesterolaemia or mixed dyslipidaemia when non-pharmacological treatments (e.g. diet, exercise, weight reduction) are inadequate, or for reduction of cardiovascular morbidity and mortality in manifest atherosclerotic cardiovascular disease or diabetes mellitus
Diagnosis, prevention, and management of statin adverse effects and intolerance Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update - Canadian Journal of Cardiology Email/Username: Password: Remember me Search Terms Search within Search Share this page Volume 29, Issue 12, Pages 1553–1568 Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Working Group Consensus Update x G.B. John Mancini (...) text, please login as a subscribed user or . Click to view the full text on ScienceDirect. Abstract The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas
Statins and cognition: a systematic review and meta-analysis of short- and long-term cognitive effects To evaluate the effect of statins on short-term cognitive function and the long-term incidence of dementia.A systematic search was performed of MEDLINE, EMBASE, and the Cochrane Central Register from their inception to April 25, 2013. Adults with no history of cognitive dysfunction treated with statins were included from high-quality randomized controlled trials and prospective cohort studies (...) after formal bias assessment.Sixteen studies were included in qualitative synthesis and 11 in quantitative synthesis. Short-term trials did not show a consistent effect of statin therapy on cognitive end points. Digit Symbol Substitution Testing (a well-validated measure of cognitive function) was the most common short-term end point, with no significant differences in the mean change from baseline to follow-up between the statin and placebo groups (mean change, 1.65; 95% CI, -0.03 to 3.32; 296
Effect of evolocumab or ezetimibe added to moderate- or high-intensity statin therapy on LDL-C lowering in patients with hypercholesterolemia: the LAPLACE-2 randomized clinical trial. In phase 2 studies, evolocumab, a fully human monoclonal antibody to PCSK9, reduced LDL-C levels in patients receiving statin therapy.To evaluate the efficacy and tolerability of evolocumab when used in combination with a moderate- vs high-intensity statin.Phase 3, 12-week, randomized, double-blind, placebo (...) - and ezetimibe-controlled study conducted between January and December of 2013 in patients with primary hypercholesterolemia and mixed dyslipidemia at 198 sites in 17 countries.Patients (n = 2067) were randomized to 1 of 24 treatment groups in 2 steps. Patients were initially randomized to a daily, moderate-intensity (atorvastatin [10 mg], simvastatin [40 mg], or rosuvastatin [5 mg]) or high-intensity (atorvastatin [80 mg], rosuvastatin [40 mg]) statin. After a 4-week lipid-stabilization period, patients (n
Meta-analysis of side effects of statins shows need for trial transparency. 24780760 2014 06 02 2018 10 23 1756-1833 348 2014 Apr 29 BMJ (Clinical research ed.) BMJ Meta-analysis of side effects of statins shows need for trial transparency. g2940 10.1136/bmj.g2940 bmj.g2940 Goldacre Ben B London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. eng Letter 2014 04 29 England BMJ 8900488 0959-8138 0 Hydroxymethylglutaryl-CoA Reductase Inhibitors AIM IM Clinical Trials as Topic