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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

METEOR Trial crash lands

The Journal of the American Medical Association has published the results of the METEOR Trial. The Full Study is currently available as an Early Release Article.

The study compared therapy with rosuvastatin 40mg against placebo over 2 years in patients with a Framingham risk score of less than 10% in 10 years in terms of the carotid intima-media thickness (CIMT).

CIMT thickening is related to development of coronary atherosclerosis however the relationship is not entirely clear. The European Heart Journal recently published a paper that concluded there was only a modest relationship and that further work is required.

The results of the METEOR Trial were expected to show regression of CIMT in the rosuvastatin arm. While the active arm of the study was statistically different from the placebo arm they were not strong enough to confirm regression, only stabilisation.

This trial does not change current practice. The design of the study was to give top doses of a potent statin to individuals at very low risk of cardiovascular events. This is not recommended in primary care because the cost of treatment compared to the marginal cardiovascular benefits in an already low-risk group makes the intervention economically nonviable. It is also worth remembering that rosuvastatin has no data for reductions in the incidence of deaths, heart attacks and other cardiovascular events.

Action: Simvastatin 40mg remains the statin of choice for lipid lowering therapy as required in the prevention of cardiovascular events.

Source: PharmaGossip

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