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 Disease