A COMPREHENSIVE REVIEW OF REAL-WORLD EVIDENCE ASSESSING THE EFFECTIVENESS OF STATINS IN MANAGING LIPID LEVELS WAS CONDUCTED.

Abstract

Introduction: On a global scale, dyslipidemia is a crucial, modifiable factor in the risk of heart attacks. To address this, we conducted a thorough review and analysis to shed light on the safety and effectiveness of treatments for lowering lipid levels, with a specific focus on comparing the impact of different levels of statin therapy.

Method: We conducted a comprehensive search of MEDLINE, EMBASE, and Cochrane databases to locate research on the protective effects of lipid-lowering treatments, particularly against Coronary Heart Disease (CHD). Two independent reviewers initially screened titles and abstracts to identify relevant studies and eliminate irrelevant, duplicate, or review articles. A thorough examination of these selected studies further refined the selection by excluding non-relevant research. Our inclusion criteria consisted of clinical trials published in English in the last ten years, involving CHD patients, and examining lipid-lowering treatments. The primary outcomes assessed were mortality rates or percentages.

Results: We included a total of seventy-five randomized controlled trials (RCTs) that directly compared different statins. While the baseline characteristics were generally consistent across the studies, there were some exceptions in the studies related to rosuvastatin. The trials showed that doses of atorvastatin 10 mg, fluvastatin 80 mg, lovastatin 40–80 mg, and simvastatin 20 mg reduced LDL-C by 30–40%, while doses of fluvastatin 40 mg, lovastatin 10–20 mg, pravastatin 20–40 mg, and simvastatin 10 mg achieved a 20–30% reduction. Only rosuvastatin and atorvastatin, at daily doses of 20 mg or more, were found to be capable of reducing LDL-C by over 40%. The meta-analysis showed a statistically significant, but clinically small, difference (less than 7%) in cholesterol reduction among statins. There was insufficient data to compare the effects of statins on the prevention of coronary heart disease and safety outcomes.

Conclusion: The consistent effects of increasing HDL and reducing triglycerides are observed across different statins when adjusted for equivalent dosages. At present, the existing evidence does not sufficiently establish the relative safety or comparative effectiveness of different statins in preventing coronary heart disease.