UNASSIGNED: LBA9514 Background: For @entity1 with life-threatening illness such as @entity5 , optimal management of longstanding medications prescribed for comorbid illness is uncertain. Risks may outweigh benefits; e.g., benefits from HMG Co-A reductase inhibitors (" @entity6817 ") may take years to accrue and may not be relevant for a @entity1 with limited prognosis. Is it safe to discontinue @entity6817 for the @entity1 with less than a year to live? METHODS: This was a multicenter, unblinded pragmatic trial. At enrollment, @entity1 were randomized (1:1) to discontinue or continue their statin medication. Eligible @entity1 were adults with advanced life-limiting illness on a statin for >= 3 months for primary or secondary prevention, a life expectancy of greater than one month, and evidence of recent deterioration in performance status. Outcomes measured at baseline and at least monthly included survival, cardiovascular-related events, quality of life (QOL), symptoms, and polypharmacy. Rate of @entity204 within 60 days of randomization was the primary outcome. RESULTS: 381 @entity1 were enrolled (189 discontinue @entity6817 ; 192 continue @entity6817 ). Mean age was 74 years (SD 12); 22% were cognitively impaired; 49% had @entity5 as the primary diagnosis; and, 69% had used @entity6817 for >5 years. Rate of @entity204 within 60 days was not statistically different between groups (discontinue vs. continue, 23.8% vs. 20.3%, 90% CI -3.5% to 10.5%, p=0.36). The group discontinuing @entity6817 had longer median time-to- @entity204 (229 days [90% CI 186-332] vs. 190 days [90% CI 170-257]; p=0.60). Total QOL was significantly better among the group discontinuing @entity6817 (McGill QOL: 7.11 vs. 6.85, p=0.037) and there were fewer symptoms in this group (Edmonton Symptom Assessment Scale: 25.2 vs. 27.4, p=0.128). @entity1 in the discontinue @entity6817 group took significantly fewer medications (10.1 vs. 10.8, p = 0.034). Few @entity1 in either group experienced cardiovascular events (13 vs. 11). CONCLUSIONS: In the setting of life-limiting illness such as @entity5 , it is unlikely that harm will accrue when @entity6817 being used for primary or secondary prevention are discontinued; these @entity1 may even benefit. CLINICAL TRIAL INFORMATION: NCT01415934.

Managing comorbidities in oncology: A multisite randomized controlled trial of continuing versus discontinuing XXXX in the setting of life-limiting illness.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'person', 'People'] @entity6817 :: ('D019821', 'Chemical') :: ['statins'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer', 'advanced cancer']
@entity6817 :: (D019821,Chemical) :: ['statins']
