Statins after 70 prevent heart attacks and strokes, but do not buy disability-free years

The edition in brief

STAREE randomised 9,971 Australians aged 70 or older without cardiovascular disease, diabetes or dementia to atorvastatin 40 mg or placebo. Over a median 5.9 years atorvastatin reduced major cardiovascular events by 30% (HR 0.70, 95% CI 0.61–0.82), about 4.6 fewer events per 1,000 person-years, but did not improve the composite of death, dementia or persistent disability (HR 0.94, 0.84–1.05). The NHS-Galleri trial of 142,250 people aged 50–77 found three annual rounds of a multicancer blood test did not reduce stage III–IV cancers (IRR 1.03, 0.92–1.14); a possible fall in stage IV cancers (IRR 0.86, 0.74–1.00) needs longer follow-up. ACHIEVE-4 showed the oral non-peptide GLP-1 agonist orforglipron was non-inferior to insulin glargine for major cardiovascular events in 2,749 adults with type 2 diabetes and established cardiovascular or kidney disease (HR 0.84, 0.59–1.20), with less hypoglycaemia but more gastrointestinal effects. In adults with Philadelphia-positive acute lymphoblastic leukaemia, frontline ponatinib plus blinatumomab gave 24-month event-free survival of 86% versus 67% with imatinib and chemotherapy, with few patients going on to transplant.