In the United States, coronary heart disease (CHD) and cardiovascular disease (CVD) account for nearly 40% of all deaths each year. High levels of cholesterol, or hypercholesterolemia, are an important risk factor for CHD. The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-CoA) reductase inhibitors, also known as statins, are the most effective class of drugs for lowering serum low-density lipoprotein cholesterol (LDL-c) concentrations. The purpose of this review is to compare the efficacy and adverse effects of different statins.

Contents

• Introduction
  • Scope and Key Questions
• Methods
  • Literature Search
  • Eligibility Criteria and Study Selection
  • Data Abstraction
  • Validity Assessment
  • Data Synthesis
• Results
  • Key Question 1. How do statins compare in their ability to reduce LDL-c?
  • Key Question 2. How do statins compare in their ability to increase HDL-c?
  • Key Question 3. How do statins compare in their ability to reduce the risk of nonfatal myocardial infarction, angina, CHD mortality, all-cause mortality, stroke or need for revascularization (coronary artery bypass graft, angioplasty or stenting)?
  • Revascularization Studies with Restenosis or Clinical Outcome Endpoints
  • Key Question 4. Are there differences in the efficacy or safety of statins in different demographic groups (age, sex, race)?
  • Key Question 5. Are there differences in the safety of statins?
• Summary of Evidence
• References
• Appendixes
  • Appendix A. Search strategy
  • Appendix B. Quality assessment methods for drug class reviews for the Drug Effectiveness Review Project
  • Appendix C. Excluded trials
• Evidence Tables

The funding source, the Center for Evidence-based Policy, is supported by 17 organizations, including 15 state Medicaid programs. These organizations selected the topic and had input into the Key Questions for this review. The content and conclusions of the review are entirely determined by the Evidence-based Practice Center researchers. The authors of this report have no financial interest in any company that makes or distributes the products reviewed in this report.

Suggested citation:

Helfand, Mark, Carson, Susan, Kelley, Cathy. Drug Class Review on HMG-CoA Reductase Inhibitors (Statins). 2006. http://www.ohsu.edu/drugeffectiveness/reports/final.cfm

The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug,use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports.