Médecine
MENUL'arrêt d'un traitement par statines est-il dangereux ? Volume 9, numéro 10, Décembre 2013
Illustrations
- Mots-clés : dyslipidémies, inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase
- DOI : 10.1684/med.2013.1038
- Page(s) : 449-52
- Année de parution : 2013
A statin therapy has complex issues and is subject to many determinants, where the influence of the industry marketing these drugs is intense. In the present state of the data, we can only agree with the goal of preventing or reducing cardiovascular risk, which covers a different reality than the numbers of cholesterol... What matters is the risk of death: the lower it is, the smaller the absolute benefit is (which matters for the patient). Stopping an “ineffective” treatment because it is not justified is inconsequential. Conversely, if the hypothesis of a direct action of statins on the disease process motivating the prescription is correct, the recovery process says it is logical to stop the treatment. The main question to which no current clinical trial can answer, deals with one of possible “rebound effect”, with another issue that questions the treatment for the durability of its effectiveness. The decision to prescribe or not, or to stop or not, with the “informed” patients' agreement, can only be based on a closer analysis of the reality of their way of life and the possibilities for them to change it.