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Monday, March 26th 2007

Denouncing Statins From The Keyboard

British physician James LeFanu denounces the overuse of statins in The Telegraph.

Statins are useless for 95 per cent of those taking them, while exposing all to the hazard of serious side-effects. Hence my ever-growing file of letters from those who regrettably have had to find this out for themselves, illustrated by this all-too-typical tale from Roger Andrews of Hertfordshire, first prescribed statins after an operation for an aortic aneurism (that he had cleverly diagnosed himself).

Dr. LeFanu’s argument is that the money in statins (and there is a LOT) cloud the research into a rosier than actually is picture and that somehow his stories from those patients on statins who have written him show the truth.

There’s something wrong with that logic. I’m not saying we shouldn’t be wary of pharma funded research or the promotion of drugs – that is the age old discussion. But Dr. LeFanu appears to be committing cardinal sins in judging statins (or, for that matter, if he was judging anything else). He figures himself gifted enough (and I’m sure he’s very talented) to deduce off a very limited and small number of observations.

This is the way the human brain is hard wired, but Dr. Lefanu should probably work to step away from it. If I kick a rock twice during a thunderstorm and lightning streaks across the sky both times I might figure a casual relationship. Of course, from all else I know I’d be a moron to do so.

Here’s the rest of the story of Roger Andrews of Hertsfordshire,

Over the past few years Mr Andrews had become increasingly decrepit -what can one expect at 74? – with pain and stiffness in the legs and burning sensations in the hands so bad that when flying to his son’s wedding in Hawaii he needed walking sticks and a wheelchair at the transfer stops. However, he forgot to pack his statins, and felt so much better after his three-week holiday that when he got home he decided to continue the inadvertent “experiment” of not taking them. Since October most if not all of his crippling side-effects have gone. Several friends can tell a similar story, and they have friends too\u2026

From this singular tale Dr. LeFanu jumps to the conclusion that,

statins are only of value in those with a strong family history of heart disease or men with a history of heart attacks. For everyone else they are best avoided as they seriously interfere with the functioning of the nerve cells, affecting mental function, and muscles.

Okay, there might be some rare cognitive S/Es with statins. Take the UCSD statin effects study. But they certainly don’t seem to show up as a major and notable side effect in the literature, alongside say myopathy.

Trade Name Baycol Was Recalled For Cases of Rhabdomyolysis

I don’t know nearly enough to nod my head at the proposal by a lecturer that everyone should be on statins (less shocking than it might sound), but it appears Dr. LeFanu is in the far, far minority when it comes to medicine’s general opinion on statins.

“They are a remarkably safe class of drugs,” said Dr. Maron. “Given the huge market experience and the careful clinical trial experience, all the statins on the market have a very clean record.”

Recent data from the Heart Protection Study, for example, show that even relatively young people who have no heart disease and scant blood levels of low-density lipoprotein (LDL) cholesterol can dramatically lower their risk of suffering a heart attack or other cardiac event by taking simvastatin.

Maybe Dr. LeFanu should throw some actual citations and research into the next column he churns out from his computer.

[Statins For Those With CV Risks: Health Protection Study Summary]