CHICAGO, IL— Discontinuation of statin therapy does not shorten survival and improves quality of life among patients with a life expectancy of less than 1 year, according to findings from a randomized controlled trial presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting.
“Our study provides the first evidence that stopping statins is safe and improves patient quality of life,” said lead author Amy P. Abernethy, MD, PhD, a medical oncologist and palliative care specialist at Duke University Medical Center in Durham, NC.
Dr. Abernethy’s team enrolled a total of 381 patients in the study, including 49 with cancer. Participants had a life expectancy between 1 month and 1 year and had been taking a statin for at least 3 months. A total of 70% of patients had been taking statins for more than 5 years, Dr. Abernethy noted. Patients were randomly assigned to continue or discontinue statin therapy.
Because statins reduce the risk of heart attack and stroke, some clinicians are reluctant to discontinue their use by patients with life-limiting illnesses. But most benefits from statins accrue only after 2 years, raising questions about their utility for patients with life-limiting disease.
The new study found no significant difference in mortality rates between the two study arms within 60 days (20.3% vs. 23.8%). Patients who discontinued statin therapy had a longer median time-to-death (229 vs. 190 days), but this difference was not statistically significant (P = 0.60).
“Total quality of life was significantly better among the group discontinuing statins and there were fewer symptoms in this group,” Dr. Abernethy reported. “Few participants in either group experienced cardiovascular events (13 vs. 11 patients).”
“Discontinuing chronically administered medications near the end of life has (received) limited study,” commented Patricia Ganz, MD, FASCO. “No one wants to ‘rock the boat’ at this stage of life …However, now we have evidence that discontinuing certain medications is safe, specifically in the case of the widely prescribed statin drugs, and can improve quality of life for patients.”
Patients with terminal diseases typically take 10 or more medications during the final year of life, Dr. Abernethy reported.
- Abernethy AP, Kutner J, Blatchford PJ et al. Abstract LBA9514. Presented at: 2014 American Society of Clinical Oncology (ASCO) Annual Meeting; May 30-June 3, 2014; Chicago, IL.