Healthy Skepticism Library item: 12762

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Donner-banzhoff N, Sönnichsen A.
Strategies for prescribing statins
BMJ 2008; 336:(7639):288
http://www.bmj.com/cgi/content/extract/336/7639/288?etoc

Abstract:

Five years ago the “fire and forget approach” was proposed as a strategy for prescribing lipid lowering drugs.1 It involves prescribing a standard dose of statins to patients at high risk of cardiovascular disease without further testing or dose adjustment. This strategy was contrasted to the “treat to target strategy,” which aims to achieve target concentrations of low density lipoprotein by titrating drugs and other measures accordingly.

Since then, several trials have shown that high dose statins in a supposed treat to target approach are more effective than the standard dose. Accordingly, the United Kingdom quality and outcomes framework and the Scottish Intercollegiate Guidelines Network guideline number 97 emphasise the importance of measuring cholesterol and having targets.2 So, is the treat to target strategy now the best option?

None of the large statin trials used the treat to target strategy suggested by most lipid experts, and none was based on . .