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Results: 8

Comparing Statins and Combination Drugs

How do statins and combination drugs compare in lowering "bad" cholesterol (LDL-c)?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: November 1, 2010

There good evidence that statins given in late life to individuals at risk of vascular disease have no effect in preventing dementia

Evidence accumulating from biological and epidemiological studies suggest that high levels of serum cholesterol may promote the pathological processes that lead to Alzheimer's disease. Lowering cholesterol in experimental animal models slows the expression of Alzheimer's pathology. These findings raise the possibility that treating humans with cholesterol lowering medications might reduce the risk of developing Alzheimer's disease. The statin family of medications (lovastatin, pravastatin,simvastatin, and others) are powerful cholesterol lowering agents of proven benefit in vascular disease. Several clinical studies comparing the occurrence of Alzheimer's disease between users of statins and non‐users of statins suggest that risk of Alzheimer's disease is substantially reduced among the users. However, because these studies are not randomized trials, they provide insufficient evidence to recommend statin therapy. Two randomized trials have since been carried out and neither showed any reduction in occurrence of AD or dementia in patients treated with statins compared to those given placebo. Statins cannot therefore be recommended for the prevention of AD or dementia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Medication for the treatment of high cholesterol levels

High cholesterol levels could mean an increased risk of cardiovascular disease. Certain medications that reduce cholesterol levels can prevent related health problems and increase life expectancy. Whether or not it is worth taking these medications will depend on what other risk factors you have.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 29, 2013

Heart disease and diabetes: Which statins have been well-investigated?

All of the five different statins that are licensed for use in Germany can lower the cholesterol level in the blood. But the deciding factor for patients is how well the medicine can prevent heart attacks and other coronary artery problems. From this point of view, simvastatin (marketed under various brand names) is the best tested. It has been shown to lengthen life expectancy of people with diabetes and particular heart diseases.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 10, 2011

Coronary artery disease: What can I expect from taking statins?

Statins have been proven to lower the risk of heart attack and stroke in people who have coronary artery disease, and to improve their life expectancy. Most people tolerate the drug fairly well.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2013

Lipid‐lowering agents for nephrotic syndrome

Nephrotic syndrome is a relatively rare disease in which the kidneys leak protein into the urine. A common early sign is swelling in the feet and face. Other signs and symptoms of nephrotic syndrome include low levels of protein in the blood, and high levels of fats in the blood, particularly cholesterol and triglycerides.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Statins for non‐alcoholic steatohepatitis

Non‐alcoholic fatty liver disease (NAFLD) and non‐alcoholic steatohepatitis (NASH) in patients with no or very little alcohol consumption is characterised by hepatic histological changes similar to those associated with alcohol‐induced liver injury. A range of histological changes can be seen. Some patients have fat accumulation in hepatocytes without significant inflammation or fibrosis (simple hepatic steatosis or NAFLD), but others have hepatic steatosis with prominent necro‐inflammatory changes with or without associated fibrosis (this is NASH). Although NAFLD and NASH are common conditions, no effective medical treatment is available to correct the abnormal liver enzymes and adverse outcomes associated with them. This systematic review identified two randomised clinical trials with very small numbers of participants. One of the trials was a pilot trial and compared simvastatin with placebo, and the other trial assessed atorvastatin versus fenofibrate versus a combination of the two. The small pilot trial (n = 16 patients) assessing simvastatin versus placebo in NASH patients did not show significant effects on liver enzyme activities or liver histology. No adverse events were reported. The other trial compared atorvastatin versus fenofibrate versus a group receiving both interventions in 186 patients with NAFLD. There were no statistically significant differences between any of the three intervention groups regarding the 54 week mean activities of aspartate aminotransferase, alanine aminotransferase, gamma‐glutamyl transpeptidase, or alkaline phosphatases (liver enzymes) in the blood. The triglyceride levels seemed higher in the fenofibrate group compared with the atorvastatin group. Liver histology was not assessed in this trial. The presence of biochemical and ultrasonographic evidence of NAFLD seemed higher in the fenofibrate group compared with the other two intervention groups. Three patients discontinued treatment due to myalgia and elevated serum creatine kinase activity, one from the atorvastatin group and two from the combination group. Another patient from the atorvastatin group discontinued treatment due to raised alanine aminotransferase activity, over three times the upper normal limit. Both trials were at high risk of bias (that is, overestimation of benefits and underestimation of harms). Furthermore, the groups were small raising the risks of random errors (that is, play of chance). Accordingly, we did not find evidence to support or refute the use of statins for patients with NAFLD or NASH. Further unbiased trials with larger numbers of patients looking explicitly at patient‐related outcomes of interest (for example, quality of life, development of cirrhosis, and mortality) are needed to assess the effects of statins on NAFLD or NASH.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Fact sheet: Medication for long-term treatment of CAD

The most important part of long-term treatment for coronary artery disease (CAD) is taking medication. The different types of drugs aim to both reduce symptoms and prevent complications.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2013

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