Long-term follow-up of lipid-lowering trials

Packard, C. and Ford, I. (2015) Long-term follow-up of lipid-lowering trials. Current Opinion in Lipidology, 26(6), pp. 572-579. (doi: 10.1097/mol.0000000000000230) (PMID:26780010)

Abstract

Purpose of review: Most LDL-lowering trials are limited in duration while the disease process occurs over decades. It is informative, therefore, to evaluate the long-term effects of treatment by undertaking extended observation beyond the formal double-blind phase of intervention studies. The current review brings together the findings of major trials that have conducted such long-term follow-up. Recent findings: Extended observation of trial cohorts has reinforced the long-term safety of LDL-lowering therapy (with statins and other agents), with no evidence of late development of cancers or other adverse outcomes. Post-trial follow-up reveals also legacy benefits in terms of improved survival (due principally to decreased cardiovascular death rates), and lower hospitalization rates for cardiovascular disease. A number of trials report further risk reduction even after the formal intervention has ceased, and the appearance of delayed benefits such as reduced rate of heart failure. Summary: The perceived value of LDL lowering is enhanced significantly by the legacy benefits that persist after administration of treatment to individuals with established coronary heart disease or to those at high risk of developing disease. Safety, efficacy and the economics of intervention can be judged more fully in light of the knowledge gained from extended observation in clinical trials.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ford, Professor Ian and Packard, Professor Chris
• Authors: Packard, C., and Ford, I.
• College/School: College of Medical Veterinary and Life Sciences; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Current Opinion in Lipidology
• Publisher: Lippincott Williams & Wilkins, Ltd.
• ISSN: 0957-9672
• ISSN (Online): 1473-6535
• Copyright Holders: Copyright © 2015 Wolters Kluwer Health, Inc.
• First Published: First published in Current Opinion in Lipidology 26(6):572-579
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher