Cholesterol-Lowering Drugs are Less Effective in Reality than in Trials

Cholesterol-lowering statin drugs work to lower ?bad? LDL cholesterol in clinical trials, however, in reality many patients do not stick to the pill-taking routine, rendering the treatment less effective than initially thought.

According to a recent study of 400 new statin users, levels of LDL cholesterol were lowered one-third less than expected from clinical trials. Three statin drugs, atorvastatin (Lipitor), simvastatin (Zocor) and pravastatin (Pravachol), were involved in the study and all three yielded similar results.

The gap between expected and actual outcomes may be due to patients? adherence to the medications as well as diet, researchers say.

Additionally, some patients responded highly to the drugs while others did not. According to researchers, this variation indicates that poor results are likely due to a low compliance with treatment recommendations.

Patients may not adhere to statin therapy, which has been shown to lower the risk of both LDL cholesterol and the risk of heart attack, for several reasons. Researchers mention monetary reasons, concerns about the drug’s safety and simply not remembering as possible reasons.

Though statins are thought to be generally safe, one such drug, Baycol (cerivastatin), was recently recalled due to adverse side effects including severe muscle weakness and several deaths from rhabdomyolysis, which causes muscle to break down.

The recall has raised fears over statin side effects; however several national institutes, including the American Heart Association and the American College of Cardiology, have recently stated that the drugs are safe and effective in treating high cholesterol.

American Journal of Medicine December 2002;113:625-629