Safety profiles for the HMG-CoA reductase inhibitors - Treatment and trust

Hypercholesterolaemia is a chronic condition that often requires life-long treatment, making the safety of lipid-lowering drugs a critical issue. 3-hy droxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors ('statins' ) are commonly used as the pharmacotherapeutic treatment of choice for pati ents with hypercholesterolaemia. These agents have consistently demonstrate d a positive safety and tolerability profile, and are recommended by the US National Cholesterol Education Program guidelines and by the European Join t Task Force for Prevention of Coronary Heart Disease to be used after, or in addition to, a first-line approach with diet. Several large-scale clinic al trials have shown HMG-CoA reductase inhibitors to be efficacious and wel l tolerated, and to be associated with a low rate of treatment withdrawal d ue to adverse events. These studies included mortality and morbidity end-po ints, and comprised both primary- and secondary-prevention trials. Hepatic, renal and muscular systems are rarely affected during HMG-CoA reductase in hibitor therapy and the few drug interactions that can occur with concomita ntly administered drugs are well documented. There is no conclusive evidenc e linking HMG-CoA reductase inhibitors to the development of cancer in huma ns. In long term studies with various HMG-CoA reductase inhibitors, there w as no increase in cancer rates compared with placebo. Thus, it can be concl uded that HMG-CoA reductase inhibitors ale well tolerated, effective treatm ents for hypercholesterolaemia.