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NICE rejects arguments against wider statin use

Evidence is there to support safe use of statins, says NICE

Adrian O'Dowd

Monday, 10 November 2014

The head of the NHS’s main body that provides national guidance and advice to improve health care has rejected recent arguments that questioned the safety of doctors prescribing statins to patients.

Professor David Haslam, chair of the National Institute for Health and Care Excellence (NICE) has written a letter to the parliamentary health select committee defending NICE’s stance on statins.

The move follows a recent open letter sent to the health committee, signed by several doctors including representatives from the BMA, which called for the committee to independently investigate NICE in relation to its systems designed to deal with conflicts of interest of its guideline development group panels.

These doctors also highlighted recent research that suggested that statins do not reduce overall mortality or serious illness in people with a 10% risk of heart disease.

Responding the open letter, NICE’s chair Professor Haslam, a GP for more than 30 years, said good evidence supported the wider use of statins in preventing heart attacks and stroke and that there were safe and effective.

Professor Haslam said that statins had been widely used in developed health care systems to protect people from cardiovascular disease (CVD) for almost 30 years.

“Their use in people who have established cardiovascular disease is not controversial,” he said. “The use of statins to prevent the development of cardiovascular disease in well people is a more recent role but is equally widespread and robustly evidence-based.

“The evidence is clear, in our view, that statins have a material impact on reducing cardiovascular risk, where that risk is greater than 10% over a 10 year period. We are not advocating that statins are the only appropriate intervention. Our clinical guideline sets out to identify people at increased risk of CVD and argues for changes to diet and exercise where that can be achieved.

“It is only if lifestyle changes on their own are not sufficient, and that other risk factors such as hypertension are also managed, that people who are at risk should be offered the opportunity to use a statin, if they want to.”

It was up to people to decide of they wanted to take the drug once they had been made aware of the risks, as he added: “If they find after starting treatment that the side effects outweigh their understanding of their risk, they should be advised to stop.”

Professor Haslam also rejected the accusations questioning the independence of NICE’s advisory groups, saying: “Our advisory groups (‘panels’, to use the authors’ language) are already independent. They are recruited through open advertisement with appointments made on merit. They are informed by expert testimony and their conclusions subject to public consultation.”

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