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Statin switching 'boosts CVD risks by 30%'

By Mark Pownall

A new pharmaceutical company study has reopened the row over statin switching after claiming the move substantially increases the risk of death or cardiovascular events.

Moving patients from atorvastatin to simvastatin raised the risk of death or major CVD events by 30%, according to the analysis, conducted by Pfizer researchers and presented at the European Society of Cardiology conference in Vienna.

Researchers examined data from a primary care database of 4.77 million patients, including 2,511 patients who had been switched, and compared the switch patients with 9,009 unswitched controls who continued to receive atorvastatin.

But the analysis found significant increases of 43% in major cardiovascular events and 114% in stroke, as well as non-significant increases of about 30% in myocardial infarction and revascularisation.

Dr Berkeley Phillips, cardiovascular category medical manager at Pfizer UK and one of the researchers, said: ‘This study provides further evidence that patients should be switched only on a case by case basis, and raises questions against switching as a matter of policy.'

A previous hospital audit comparing periods before and after switching found mortality was 5% in patients on atorvastatin but 14% with simvastatin – but its methodology was criticised.

Staines GP Dr John Pittard, a member of the Primary Care Cardiovascular Society said: ‘The problem with switching is that it is usually done in a wholesale mechanistic way, and patients are treated in a one size fits all fashion.'

But Gillingham GP Dr Rubin Minhas, cardiovascular lead to Medway PCT said: ‘This is a poor quality study susceptible to confounding and bias selection. Switching between equivalent doses of statins is safe, effective and an efficient use of scarce resources.'

Dr John Pittard Pittard quote

The problem with switching is that it is usually done in a wholesale mechanistic way

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