On SGLT2i:
Statins (HR 0.97, CI 0.94-1.00) and Estrogen (HR 0.76, CI 0.67-0.85), as a class, reduced mortality, so did SGLT2i (HR 0.64, CI 0.45-0.89), although with a much lower sample size.
They looked at “SGLT2 inhibitors (Canagliflozin, Empagliflozin, Dapagliflozin)”. In the UK here were the most prescribed SGLT2i from April 2021 to April 2022:
So we can assume that dapagliflozin and empagliflozin extend lifespan.
Also, among statins, only atorvastatin had a significant positive effect on mortality:
Importantly, we identified 14 drugs that increased lifespan, compared to health matched controls (Figure 2, Data Table 2), independently of current smoking, cancer diagnosis, diabetes, gender, and age at recruitment. These included notably the statin Atorvastatin (HR 0.91, CI 0.87-0.95), the PDE5 inhibitor Sildenafil (HR 0.85, CI 0.78-0.93), the anti-inflammatory drug Naproxen (HR 0.90, CI 0.85- 0.96), and the estrogen related drugs Estraderm (HR 0.67, CI 0.51-0.88), Vagifem (HR 0.73, CI 0.59-0.91), Estriol (HR 0.74, CI 0.60-0.92) and Estradiol (HR 0.75, CI 0.59-0.95). Others included, Lymecycline, Otomize, Marvelon, and 2 vaccines (Avaxim, Revaxis).
Statins as a class had a tiny positive effect: “Statins (HR 0.97, CI 0.94-1.00)”
Does it mean that some statins have a detrimental effect? We really need the whole dataset to conclude… But in the meantime, should people prefer atorvastatin to other statins?
I also find it interesting that after simvastatin failed the ITP, they decided to test for atorvastatin.
(and what are the 2 drugs not listed out of the 14?!)
That 80 mg atorvastatin increase mortality looks like reverse causation to me.
I guess this study shows which drugs have an outsized effect when prescribed to disease process relative to healthy population? SGLT2i? (Like the metformin story long ago, that those given metformin for diabetes lived longer than healthier controls - but was debunked later?).
Yes there might be confounders. For instance for viagra, I guess people who use it tend to be in a relationship, maybe a happy one, etc. They’re also probably not hospitalized.
No sure actually. Otherwise why would atorvastatin outperform while rosuvastatin and others failed?
Actually, they did: Association between prescription drugs and all-cause mortality risk in the UK population | medRxiv
A few interesting things:
This is great, I saw that they said “as a class”, did they also say “all”?
You’re right, they did not, I clarified that point after looking at the raw data: First report from Epiterna on the search for drugs that can extend human lifespan - #10 by adssx
Atorvastatin has already been proven to be superior to rosuvastatin in terms of side effects, lower diabetes risk and cataract surgery:
So this more info in favor of atorvastatin. But has atorvastatin reduced all-cause mortality, which rosuvastatin has?
I find it odd that Naproxen is on the list as I thought NSAIDs increased the risk of death.
“It is widely considered a strong painkiller and is part of the category of medicines known as non-steroidal anti-inflammatory drugs (NSAIDs).”
“Naproxen and other nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of heart attack and stroke”
“NSAID use causes an estimated 3,300 deaths and 41,000 hospitalizations each year among older adults.”
“NSAID use is associated with an increased risk of death after one year and five years.”
Yes, there are several surprising results.
For instance, they found HR 2.15 for lithium carbonate. And yet, another Swiss team looking at the same dataset (UK Biobank) found that “Subsequent multivariate survival analyses reveal lithium to be the strongest factor in regards to increased survival effects (hazard ratio = 0.274 [0.119–0.634 CI 95%, p = 0.0023]), corresponding to 3.641 times lower (95% CI 1.577–8.407) chances of dying at a given age for lithium users compared to users of other anti-psychotic drugs.” (Lithium treatment extends human lifespan: findings from the UK Biobank 2023)
I love that Nystatin made it in the statin’s list … this is actually an anti fungal for candida (usually use for thrush or vaginal candidiasis). Anyway, not a good one for aging apparently. But also not a cholesterol medicine.
It may be because dose for longevity is much lower than for psychiatric illnesses
Doses of lithium for longevity purposes are about 20 mg / day, doses for illness are about 1800 mg / day - 90x difference
I’m sorry. It was my mistake. I simply filtered for “statin” in my spreadsheet. I’ll edit my message.
This one SHOCKED me. I’ve always felt so guilty whenever I took one if I had a headache or felt sick. Now I guess I don’t feel so badly about it. It also reduces pain before working out.
Well I guess I might have to ask my doctor to switch me from 5mg Rosuvastatin to 10mg Atorvastatin now.
I didn’t know, so why do you take rosuvastatin then?
I see no reason to switch right now to atorvastatin unless there is a large RCT that has showed benefit in all cause mortality like rosuvastatin.
Better question: If you were being prescribed statins for the first time and were given your choice of the two, which would you pick?
I wrote more on rosuvastatin over atorvastatin here:
Add in detected benefit for ACM for rosuvastatin. That’s much better. This is an association study. 10 mg atorvastatin had null effect in it.
I am thinking actually about skipping ezetimibe and going to high dose statins, because 20 mgs showed benefit in ACM in JUPITER.
