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Introduction
This is the final of three articles looking at the statin trials that have been conducted and the pooling together of those trials with the technique called meta-analysis. The Clinical Trial Service Unit (CTSU) is an academic research unit within the Nuffield Department of Population Health at the University of Oxford. The Cholesterol Treatment Trialist (CTT) group is a collaboration led by researchers from the CTSU and other institutions. The CTT group produces meta-analyses of data from statin trials to assess the effects of cholesterol-lowering drugs on cardiovascular outcomes.
The CTT collaboration has published six meta-analyses in the Lancet between 2005 and 2019. These 6 papers have included between 14 and 28 trials where either a statin was compared with a placebo or a higher dose statin was compared with a lower dose statin. The first note shared some background on the CTSU – particularly the facts that the unit has received millions from statin manufacturers and the unit treats raw data as commercially sensitive and not for sharing. Those data affect patients and should be shared.
The second note focused on the 14 trials that are included in all 6 meta-analyses. The first CTT meta-analysis (2005) involved just those 14 trials. The last CTT meta-analysis (2019) involved 28 trials. Provided that trials 15-28 didn’t have striking results against statins, adding more trials would not change and might strengthen the original findings.
This final note summarises the six CTT papers. How many people were involved? What were the characteristics of those people (women, with/without diabetes, with/without vascular disease)? What time period was reviewed? What mortality benefit was claimed (and was this robust?) What was the relative risk reduction claimed? What was the absolute risk reduction? Ditto for major vascular events? It puts claims in context given what we’re covered about statins to date. That context is where we will start…
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Zoe
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