Simvastatin in the Acute Respiratory Distress Syndrome

McAuley, Daniel F.; Laffey, John G.; O'Kane, Cecilia M; Perkins, Gavin D.; Mullan, Brian; Trinder, T John; Johnston, Paul; Hopkins, Philip; Johnston, Andrew James; McDowell, Clíona; McNally, Christine

doi:10.1056/nejmoa1403285

Cited by 395 publications

(337 citation statements)

References 17 publications

Supporting

Mentioning

322

Contrasting

Unclassified

Order By: Relevance

“…infections, [201][202][203] chronic obstructive lung disease, [204][205][206] and acute respiratory distress syndrome 207 ), but those claims have been reliably refuted by randomized trials of adequate size. [208][209][210][211][212] These findings reinforce concerns about basing inference about treatment effects on relatively small numbers of events in randomized trials or on observational studies irrespective of their size. 3,4,213,214 In summary, lowering LDL cholesterol with statin therapy has been shown to prevent both non-fatal and fatal major vascular events in a wide range of circumstances, and the absolute benefits depend chiefly on an individual's absolute risk of such events and on the magnitude of the LDL-reduction that is achieved (as well as the duration of treatment).…”

Section: Other Beneficial Effects That Have Been Attributed To Statinmentioning

confidence: 90%

Interpretation of the evidence for the efficacy and safety of statin therapy

et al. 2016

View full text Add to dashboard Cite

General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms SummaryThis review is intended to help clinicians, patients and the public make informed decisions about statin therapy for the prevention of heart attacks and strokes. It explains how the evidence that is available from randomized controlled trials yields reliable information about both the efficacy and safety of statin therapy. In addition, it discusses how claims that statins commonly cause adverse effects reflect a failure to recognise the limitations of other sources of evidence about the effects of treatment.Large-scale randomized trial evidence shows that statin therapy reduces the risk of heart attacks, ischaemic strokes and coronary revascularization procedures ("major vascular events") by about one quarter for each mmol/L reduction in low density lipoprotein (LDL) cholesterol during each year (after the first) that it continues to be taken. The absolute benefits of statin therapy depend on an individual's absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an effective low-cost statin regimen (e.g. atorvastatin 40 mg daily, costing about £2 per

show abstract

Section: Other Beneficial Effects That Have Been Attributed To Statinmentioning

confidence: 90%

Interpretation of the evidence for the efficacy and safety of statin therapy

et al. 2016

View full text Add to dashboard Cite

show abstract

“…There was no significant difference between the two groups in OI at day 7 (the primary outcome) or in any other secondary physiological outcomes. The KGF group, compared to placebo, had fewer median ventilatorfree days (1 [0-17] versus 20 [13][14][15][16][17][18][19][20][21][22] days; difference -8 days, 95% CI -17--2; P < 0·001), a longer median duration of ventilation in survivors (16 [13-30] versus 11 [8][9][10][11][12][13][14][15][16] days; difference 6 days, 95% CI 2-14; P = 0·002) and a higher mortality at 28 days (31·0% versus 9·7%; risk ratio 3·2 95% CI 1·0-10·7; P = 0·054).…”

Section: Disseminationmentioning

confidence: 99%

Keratinocyte growth factor for the treatment of the acute respiratory distress syndrome (KARE): a randomised, double-blind, placebo-controlled phase 2 trial

McAuley

Cross

Hamid

et al. 2017

The Lancet Respiratory Medicine

View full text Add to dashboard Cite

“…The concept of fragility is a construct that may help clarify just how "fragile" the results of a clinical trial may be by describing how many extra (or fewer) outcome events are required to alter a statistically significant result [11]. In both the STATInS and HARP-2 trials [12,13] an alteration of just three events would have yielded statistically significant results in favour of statin use based on mortality outcomes.…”

mentioning

confidence: 99%