Adherence to Cholesterol-Lowering Drugs May Reduce Deaths From Cancer

November 3, 2020
Darlene Dobkowski, MA

Taking cholesterol-lowering drugs may provide a mortality benefit in women with newly diagnosed colorectal cancer, breast cancer and melanoma, although more research is needed to confirm this potential association.

Results from a study published in the British Journal of Clinical Pharmacology demonstrated that adherence to lipid-lowering drugs initiated before cancer diagnosis may decrease deaths from cancer.

Lipid-lowering drugs, such as statins, are used to lower the level of low-density lipoprotein cholesterol, often referred to as “bad cholesterol,” in the blood.

“If this inverse adherence-response relationship is confirmed, cholesterol-lowering medications — primarily statins — could be repurposed as adjuvant (postsurgical) therapy to improve cancer prognosis,” Jia-Li Feng, a postdoctoral research officer at QIMR Berghofer Medical Research Institute in Brisbane, Australia, said in a press release.

Study authors assessed adherence to lipid-lowering medications in 20,046 women with newly diagnosed breast cancer, 11,719 women with newly diagnosed colorectal cancer and 6,430 women with newly diagnosed melanoma from 2003 to 2013. All women were eligible for health care expense reimbursement in Australia.

The researchers culled data for the study by linking the Australian Cancer Database with the Pharmaceutical Benefits Scheme database and the National Death Index.

The team measured adherence to lipid-lowering medication every three months for one year by noting how many pills women were dispensed during those time periods. Women were between the ages of 18 and 89 and must have been dispensed a statin at least twice to be included in the study.

Medications of interest in this study included hydrophilic statins, which are mainly absorbed by the liver, and lipophilic statins, which are taken up by various tissues in the body. Some examples of hydrophilic statins are Pravachol (pravastatin) and Crestor (rosuvastatin), while Lipitor (atorvastatin), FloLipid (simvastatin oral suspension), Zocor (simvastatin) and Lescol (fluvastatin) are lipophilic statins. Follow-up was conducted from one year after the cancer diagnosis until death or the end of the study in 2015, whichever occurred first.

At one year, adherence to lipid-lowering medications was similar to adherence before cancer diagnosis, with an average of 82%. Each 10% increase in one-year adherence to these medications was linked with an 8% reduction in mortality in women with breast cancer, an 8% reduction in mortality in women with colorectal cancer and a 3% reduction in mortality in women with melanoma.

Adhering to lipophilic statins resulted in greater reductions in cancer-specific mortality compared with hydrophilic statins, although this was not significant in melanoma.

“To the best of our knowledge, this is the first study to investigate the associations between adherence to (lipid-lowering medications) and cancer-specific survival in three biologically homogenous cohorts,” the study authors wrote. “These findings provide evidence of a potential antitumor effect and emphasize the importance of improving patients’ adherence for achieving initial mortality benefit.”

As this study was an analysis of database information, more research will be needed to confirm the potential inverse association.

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