Benefits and harms of statins in the UK population: doses versus effects

Statins, such as simvastatin and atorvastatin, are cholesterol-lowering drugs proven to reduce the risk of heart disease, but they also have known adverse effects, such as muscle pain, rarely leading to muscle damage, and an increased risk of diabetes mellitus.

Both the benefits and harms of any medication depend on the dose, and the relation between dose and effect is typically described by an equation called the Hill equation. However, there is little information on the relation between the doses of different statins and their beneficial or harmful effects.

This doctoral proposal aims to understand the relation between the doses of statins, their benefits, and their adverse effects (harms) by:

• systematically searching the literature for studies comparing different doses of a wide range of different statins;
• using the data to generate dose-response curves using network meta-analysis;
• estimating the parameters of the Hill equation for benefits and harms of statins, allowing comparisons between the different statins;
• analysing large databases of routine healthcare data from the UK. Looking for evidence of benefits and harms;
• combining the dose-response data with the clinical data to assess the risks of adverse outcomes in the general population.

Together, these results will shed light on the appropriateness of different doses of statins, and help inform the trade-off between benefit and harm.