Hipolipemiantes e câncer

Os hipolipemiantes sao medicamentos de eficacia comprovada no tratamento dos disturbios do metabolismo dos lipideos. Essas drogas reduzem a morbidade e a mortalidde em eventos cardiovasculares de forma notoria. A suspeita de que esses agentes podem aumentar o risco de câncer tem sido questionada desde o inicio de seu uso, gerando intensos debates e reanalises de ensaios clinicos sobre o assunto. Recentemente, os resultados do estudo Sinvastatin and Ezetimibe in Aortic Stenosis (SEAS) despertaram novo interesse por esse tema, pois os pacientes submetidos a terapia hipolipemiante intensiva tiveram numero aumentado de câncer em comparacao com o grupo controle. Este artigo visa a revisar os estudos em busca de evidencia sobre associacao do uso de hipolipemiantes e baixos niveis de colesterol com incidencia de câncer. Ate o momento nao ha evidencias concretas de meta-analises, seja com estatinas ou, mais recentemente, com ezetimiba, que indiquem que esses medicamentos induzam o aparecimento de neoplasias ou que elevem o risco de mortalidade pelo câncer. The efficacy of lipid-lowering agents in the treatment of lipid metabolism disorders is well established. These drugs markedly reduce morbidity and mortality in cardiovascular events. The hypothesis that lipid-lowering drugs might increase the risk of cancer has been questioned from the very beginning of their use and has been subject of intense debate and several attempts to reanalyze clinical trial data. Recently, the results of the Simvastatin and Ezetimibe in Aortic Stenosis Study (SEAS) has sparked new interest on this issue, since patients undergoing intense lipid-lowering therapy had a higher rate of cancer than the control group. This article gives an overview of the clinical evidence on the association of lipid-lowering drugs and low cholesterol levels with the incidence of cancer. So far there are no clear evidences from metanalyses, whether with statins or more recently with ezetimibe, indicating that these drugs induce the development of cancer or increase the risk of mortality due to cancer.