Simvastatin & Risk of Prostate Cancer Mortality.

[pjoshea13]

New study from Taiwan.

"This population-based cohort study demonstrated that statin use significantly decreased the mortality of PCa patients, and that this risk was inversely associated with the cumulative DDD of simvastatin therapy."

"Analysis of the cumulative defined daily dose (DDD) indicated that patients who were prescribed simvastatin ≥ 180 DDD had a dramatically decreased risk of death from PCa" - 37% less risk.

Authors start by saying that "we investigated the effect of two types of statins (simvastatin and lovastatin)", but there is no other reference to lovastatin in the Abstract.

-Patrick

ncbi.nlm.nih.gov/pubmed/296...

Front Pharmacol. 2018 Mar 22;9:225. doi: 10.3389/fphar.2018.00225. eCollection 2018.

Simvastatin Therapy for Drug Repositioning to Reduce the Risk of Prostate Cancer Mortality in Patients With Hyperlipidemia.

Chen YA1, Lin YJ2, Lin CL1,3, Lin HJ4,5, Wu HS2,6, Hsu HY1, Sun YC7, Wu HY8, Lai CH1,6,8,9, Kao CH1,10,11.

Author information

1

Graduate Institute of Basic Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.

2

Department of Medical Research, School of Chinese Medicine, China Medical University and Hospital, Taichung, Taiwan.

3

Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.

4

Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

5

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang-Ho Hospital, New Taipei City, Taiwan.

6

Department of Nursing, Asia University, Taichung, Taiwan.

7

Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.

8

Department of Microbiology and Immunology, Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

9

Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.

10

Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.

11

Department of Nuclear Medicine, PET Center, China Medical University Hospital, Taichung, Taiwan.

Abstract

Prostate cancer (PCa) is one of the most commonly diagnosed cancers in the western world, and the mortality rate from PCa in Asia has been increasing recently. Statins are potent inhibitors of 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase and are commonly used for treating hyperlipidemia, with beneficial effects for cardiovascular disease and they also exhibit anti-cancer activity. However, the protective effects of statins against PCa are controversial. In this study, we investigated the effect of two types of statins (simvastatin and lovastatin) and the mortality rate of PCa patients by using the Taiwan National Health Insurance Research Database (NHIRD). A total of 15,264 PCa patients with hyperlipidemia records and medical claims from the Registry of Catastrophic Illness were enrolled. The patients were divided into two cohorts based on their statin use before the diagnosis of PCa: statin users (n = 1,827) and non-statin users (n = 1,826). The results showed that patients who used statins exhibited a significantly reduced risk of mortality from PCa [adjusted hazard ratio (HR) = 0.84, 95% CI = 0.73-0.97]. Analysis of the cumulative defined daily dose (DDD) indicated that patients who were prescribed simvastatin ≥ 180 DDD had a dramatically decreased risk of death from PCa (adjusted HR = 0.63; 95% CI = 0.51-0.77). This population-based cohort study demonstrated that statin use significantly decreased the mortality of PCa patients, and that this risk was inversely associated with the cumulative DDD of simvastatin therapy. The results of this study revealed that statins may be used for drug repositioning and in the development of a feasible approach to prevent death from PCa.

KEYWORDS:

HMG-CoA reductase; cohort study; hyperlipidemia; prostate cancer; statin

PMID: 29623039 PMCID: PMC5874326 DOI: 10.3389/fphar.2018.00225

[cesanon]

Patrick

Can you explain a little more what is a cumulative DDD, and how I would go about calculating mine?

[pjoshea13 in reply to cesanon]

DDD - see below.

[snoraste]

This is very cryptic. I read the link, but no details about patients. Do you have the full report by any chance?

[pjoshea13 in reply to snoraste]

frontiersin.org/articles/10...

[snoraste in reply to pjoshea13]

Thank you

[BigRich]

≥ 180 DDD had a dramatically decreased risk of death from PCa" - 37% less risk. How many mg. of the statin, daily must you take to achieve 180 DDD?

Rich

[pjoshea13 in reply to BigRich]

DDD - see below.

[Litlerny]

Same question. I have been taking 40mg Simvistatin daily since prior to my PCa diagnosis in 2015. What dose achieves =/> 180 DDD. Thanks! Mark

[pjoshea13 in reply to Litlerny]

DDD - see below.

[pjoshea13]

DDD:

"The defined daily dose (DDD) is a statistical measure of drug consumption, defined by the World Health Organization (WHO). It is used to standardize the comparison of drug usage between different drugs or between different health care environments. The DDD is not to be confused with the therapeutic dose or with the dose actually prescribed by a physician for an individual patient.[1]

The WHO's definition is: "The DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults."

For more, see:

en.wikipedia.org/wiki/Defin...

-Patrick

[Litlerny]

Thanks for the clarification, PJ. 😎

Mark

[cesanon]

??? So does anyone know how to calculate the ddd for crestor?

[dave2]

To get the defined daily dose (DDD) for a drug, just Google "DDD [drug name]. DDD for simvastatin is 30 mg; DDD for lovastatin is 45 mg.

The cumulative DDD is defined as the amount of drug (expressed in DDD units) that a patient received over a one year period.

The full Taiwan study on simvastatin/lovastatin is available at frontiersin.org/articles/10... and it includes the results (p 4) for both statins at two different dose levels.

[paulofaus]

I'm still confused if DDD is 30mg/day is 180DDD 5400mg over 1 year?

This would make 15mg/day or am I making an error?

I'm currently on 20mg/day and will up it to 30mg if necessary.