The statin story continues
Statins have with been available for some time now and although our knowledge of them is vast, it would seem there is always something new to learn. According to a recent study, published in The Lancet and covered by the univadis GP news service (click here), there is more to add to the statin story. The bottom line from this new research is that, compared with conventional statin doses, intensifying statin treatment, not surprisingly, causes further reductions in low-density lipoprotein cholesterol levels. This biochemical change translated into significantly fewer vascular events. This is all good news but raises numerous points.
It is never easy to transfer this kind of important research to front line practice both in primary and secondary care. Firstly, the message must get across, which is not always easy when doctors are bombarded by research findings and other announcements on a daily basis. Secondly, there is a significant workload problem, as assessing patients and applying this new finding would require drug regimes to be altered and monitored. Also, it takes time for such research findings to percolate into established guidelines, for example those issued by NICE.
Meanwhile, medics at the coal face have to cope with the implications of this research and try to integrate it into their practice. It would be nice (no pun intended) if a respected national body made an early pronouncement on newly published research such as this. This would help front line medics assess the importance of the research at a much earlier stage.
In other news... If you thought tuberculosis (TB) was a disease of the past, then think again. According to the univadis GP news service (click here), cases have peaked at a 30-year high while drug resistant strains are also on the rise. Apart from highlighting the need to be more vigilant, these facts also indicate a need for intensive ongoing collection of statistical information about diseases.
And finally, warfarin may not be as firmly embedded in our therapeutic armoury as we think, as a competitor may be in the running. Dabigatran may be a cost-effective alternative in those with atrial fibrillation at risk of stroke, according to the univadis GP news service (click here). I am sure more research will be needed, as warfarin is still the gold standard.
Dr Harry Brown, editor-in-chief
By Dr Harry Brown