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Carcinogenicity of Lipid-Lowering Drugs FREE

JAMA. 1996;275(19):1481-1481. doi:10.1001/jama.1996.03530430023030
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To the Editor.  —The article by Drs Newman and Hulley1 on carcinogenicity of lipid-lowering drugs has created a concern among patients and physicians that currently used lipid-lowering drugs may cause cancer. This concern almost certainly has led some patients to discontinue their drugs and others to avoid initiation of therapy. To date, however, there is no direct evidence in humans that lipid-lowering drugs cause cancer. Some meta-analyses of primary prevention trials have suggested that lipid-lowering drugs may increase noncardiovascular mortality. A lack of reduction in total mortality in these analyses raised the possibility that drug-induced noncardiovascular mortality might offset benefit in reduced cardiovascular morbidity and mortality. None of the meta-analyses, however, have specifically identified cancer deaths as a cause of increased noncardiovascular mortality.Recent clinical trials have largely dispelled concerns about an increase in noncardiovascular mortality as a consequence of cholesterol lowering. For example, meta-analysis of lipid-lowering trials in

REFERENCES

Newman TB, Hulley SB.  Carcinogenicity of lipid-lowering drugs. JAMA . 1996;; 275:55-60.
Rossouw JE, Lewis B, Rifkind BM.  The value of lowering cholesterol after myocardial infarction. N Engl J Med . 1990;;323:1112-1119.
Scandinavian Simvastatin Survival Study Group.  Randomised trial of cholesterol-lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet . 1994;;344:1383-1389.
Shepherd J, Cobbe SM, Ford I, et al.  Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med . 1995;;333:1301-1307.
Dalen JE, Dalton WS.  Does lowering cholesterol cause cancer? JAMA . 1996;;275: 67-69.
Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults.  Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA . 1993;;269:3015-3023.

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Newman TB, Hulley SB.  Carcinogenicity of lipid-lowering drugs. JAMA . 1996;; 275:55-60.
Rossouw JE, Lewis B, Rifkind BM.  The value of lowering cholesterol after myocardial infarction. N Engl J Med . 1990;;323:1112-1119.
Scandinavian Simvastatin Survival Study Group.  Randomised trial of cholesterol-lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet . 1994;;344:1383-1389.
Shepherd J, Cobbe SM, Ford I, et al.  Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med . 1995;;333:1301-1307.
Dalen JE, Dalton WS.  Does lowering cholesterol cause cancer? JAMA . 1996;;275: 67-69.
Expert Panel on Detection and Treatment of High Blood Cholesterol in Adults.  Summary of the second report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel II). JAMA . 1993;;269:3015-3023.
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To understand the clinical management of acute heart failure syndromes.
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