Headlines
As reported by The Hartford Courant, January 4, 2006.
Statins' Benefit Only to Heart
Cancer-Fighting Ability Discounted
By William Hathaway
Statins are good for the heart, but the popular cholesterol-lowering drugs - including Lipitor, Zocor and Pravachol - do not appear to prevent cancer, pharmacists at the University of Connecticut report in today's issue of the Journal of the American Medical Association.
The researchers at the UConn School of Pharmacy reviewed 26 heart disease studies involving more than 73,000 subjects to determine whether statins helped prevent cancer.
They found that no type of cancer was affected by statin use and that no type of statin reduced cancer risk, said C. Michael White, associate professor of pharmacy at UConn.
"If there was anything there, we would have seen it in these clinical trials," White said.
But some scientists argue that more investigation is needed. A few recent studies suggested statins' effects might help combat cancer.
One theory has been that statins reduce inflammation; another suggests that by stopping the formation of low-density lipoprotein (LDL) cholesterol, known as "bad" cholesterol, statins set off a chain reaction that offers additional protective benefits against cancer.
The potential therapeutic value of statins was one of the hot topics of the 2005 annual meeting of the American Society of Clinical Oncology, said Dr. Carolyn Runowicz, director of the Neag Comprehensive Cancer Center at the UConn Health Center and president of the American Cancer Society.
The positive findings in at least four studies prompted the launch of several new trials to more rigorously assess those findings.
White, however, said his analysis suggests scientists will find that statins are of little value in the fight against cancer.
Studies that showed potential benefits of statins were all retrospective, White said. They compared whether people who took the drugs had more or less cancer than people who did not. Such studies are never conclusive in determining cause, White said.
For instance, it could be that people who received statin treatment for heart ailments tend to take better care of themselves.
The studies reviewed by UConn researchers, however, were more rigorous and involved placing patients randomly in treatment and non-treatment groups; patients in the non-treatment groups received placebos instead of real statins.
Those trials showed there is no point in people taking statins only to reduce the risk of cancer.
"They would have none of the benefits, but still have the risks" of taking the drugs, White said.
In some cases, statins have been implicated in liver damage and muscle weakness.
First approved by the U.S. Food and Drug Administration in 1987, statins act on an enzyme in the liver, blocking its ability to make LDL cholesterol and helping the liver process it. The class of drugs includes such well-known drugs as Lipitor (atorvastatin), Pravachol (pravastatin), Zocor (simvastatin), Lescol (fluvastatin) and Mevacor (lovastatin).
Runowicz said a few of the studies reviewed by White and his colleagues seemed to suggest statins could provide some protection from cancer, but when the data from the studies were taken together, the apparent protective effect disappeared. Runowicz said there are good biological reasons to believe statins could play a role in averting cancer. White's study shows the need for skepticism, she said, but also a need for clinical trials designed to test whether statins might prevent cancer.
Dr. Jonathan Sporn, attending physician at St. Francis/Mount Sinai Regional Cancer Center, agreed that statins should not be prescribed for cancer prevention and that more study is needed.
"These ideas have to be tested in large-scale trials," Sporn said.
But the UConn review did offer some heartening news. Collectively, the 26 studies reviewed proved conclusively that statins can dramatically help people who have heart disease, White said. "The evidence is overwhelming."