LIPID trial: latest results
Long-term follow-up of heart patients shows statin therapy is safe
After a total of 16-years of follow-up, CTC's LIPID* trial has
now shown clearly that the higher survival rate due to 6 years of
statin treatment is sustained over a long period, mainly because of
prevention of death from cardiovascular disease. Long-term
follow-up also has the reassuring finding that treatment with
statins is not related to any increase in any new cancer, cancer
death rate or death from other causes. The results have just been
made available by the journalCirculation, and will be formally
published very soon.
The LIPID trial was a major early achievement of the CTC. In the
early 1990s, the trial recruited over 9000 patients who had
recently had a coronary event but who had normal cholesterol
levels. These patients, from 87 hospitals in Australia and New
Zealand, were randomised to pravastatin or placebo and then
followed up for 6 years. The treatment significantly and
cost-effectively reduced mortality and major cardiovascular events.
Overall mortality was reduced by 23% and death from coronary heart
disease by 24%. Clinical evidence from LIPID enabled subsidy for
pravastatin treatment through the Pharmaceutical Benefits Scheme
and change in the Australian treatment guidelines.
After the 6 years of the trial finished, participants were all
offered treatment with pravastatin, and most continued with it.
During the years of extended follow-up, almost the same proportion
of each group received statin therapy (about 85%).
The longer-term effects of statins on net clinical benefit had
previously been debated, particularly in relation to effects on
cancer and other serious disorders. As part of the follow-up study,
the LIPID investigators particularly focused on cancers and, for
further reassurance, also conducted a meta-analysis of the cancer
data available from other similar statin trials. This meta-analysis
resulted in conclusions that the original randomized groups had no
significant difference in cancer mortality or cancer incidence,
during the trials or the long period afterward.
29 March 2016
*LIPID -- Long-term Intervention with Pravastatin in Ischaemic