Stopping the Use of Cholesterol-Lowering Drugs Near the End of Life Improves Quality of Life

ASCO Annual Meeting
May 30, 2014

According to new research, people who are expected to live less than a year can safely stop taking cholesterol-lowering drugs, known as statins, without shortening their lives. In fact, discontinuing statins provided a number of important benefits, including reducing symptoms, having to take fewer pills, and improving overall quality of life.

The number of medications people with a life-limiting illness must take doubles during the last year of their lives. This often means people are taking 10 or more different pills per day—a difficult task for patients who frequently have trouble swallowing and a poor appetite. In addition, the side effects of each medication accumulate, and new side effects often develop when a number of drugs are taken together. These interactions between drugs can also reduce how well each individual treatment works.

For this study, 381 patients with a life-limiting illness (49% had cancer) and a life expectancy between one month and one year were divided into two groups. One group continued taking their statin as prescribed, while the other stopped statin therapy. The researchers found that stopping statin use was safe. Few patients in either group (13 in the group that stopped versus 11 in the group that continued) experienced the cardiovascular complications statins are prescribed to prevent, such as heart attacks. In fact, half of the group that discontinued statins were alive after 229 days compared with 190 days in the group that continued statin therapy. The patients who stopped taking their statins had a better quality of life and tended to have fewer symptoms. They also took fewer medications overall compared with patients who continued taking statins.

What this means for patients

“Many doctors argue that, near the end of life, it is not necessary to continue medications for chronic illnesses that are not life-threatening. But we have no guidance on which medicines to stop and when to do so,” said lead study author Amy P. Abernethy, MD, PhD, a medical oncologist and palliative care specialist at Duke University Medical Center in Durham, NC. “Our study provides the first evidence that stopping statins is safe and improves patients’ quality of life.” However, Dr. Abernethy noted that discontinuing statins is not appropriate for every patient, and the decision should be made on an individual patient basis.

Questions to ask your doctor

  • What is my prognosis (chance of recovery)?
  • What is the purpose of each of my medications?
  • Is there a chance that any of my medications could interact?
  • What should I do if I experience any unexpected side effects to my medications?
  • What are the potential risks and benefits of stopping one or more of my medications, such as statins?

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