Friday, October 21, 2005

Trust Your Doctor? Fool Me Once…

I take a large dose of lovastatin, the generic version of Mevacor, the first cholesterol-lowering drug in the “statin” class to hit the market almost 2 decades ago. I have a genetic predisposition to producing an abnormally high amount of low density lipoproteins, or L.D.L.’s, which are considered the “bad” cholesterol that can deposit plaque on arteries which causes heart disease blockage and heart attacks.

The advent of the statin drugs, which act on the liver to make it produce less cholesterol, was, for me, like the development of penicillin to fight bacterial infections—it meant hopefully living longer for those of us condemned to possibly developing early major cardiovascular disease from birth.

Or, so I thought since the late 1980’s. My personal health is an issue with an op-ed piece in today’s Los Angeles Times:

IS POPPING A PILL the best way to reduce your risk of a heart attack?

That's the message Americans and their doctors hear almost every day. The Journal of the American Medical Assn., for instance, reports in its Oct. 12 issue that the growing use of statin drugs in the United States is largely responsible for falling cholesterol levels over the last decade. Coupled with new data showing that the number of heart disease deaths is falling in the U.S., it sounds like great news.

Unfortunately, putting those two facts together gives Americans the wrong prescription for the most effective way to minimize their risk of heart disease.

First of all, cholesterol levels in the U.S. actually fell faster before
statins entered widespread use in the early 1990s, as some Americans decreased their consumption of saturated fats. But, despite the falling cholesterol levels, National Institutes of Health [NIH] data show that the U.S. is still lagging badly behind most of the other industrialized countries in eliminating heart disease as a major cause of premature death.-- Pills to avoid heart attacks? Hard to swallow By John Abramson and Merrill Goozner

It’s not like I was ignorant of big pharma’s numero uno goal--as Michael Moore so succinctly nailed when questioned on a talk show about his next documentary venture into the multi-billion-dollar drug business—make money and increase the profit margin for the shareholders. (My apologies for not mentioning the untold numbers of others who have also publicly tried to make this truth abundantly public, and clear.)

In my own defense, I did write in this blog last April about the cross-purposes of several physicians working for the NIH and also being paid by drug companies who manufacture statins, to promote those statins in the media. At that time, I wrote,

When I last had my dosage of mevacor, a cholesterol-lowering statin “wonder” drug, doubled, I asked my physician if there was any concern long-term regarding cancer or any bad side effects. He replied, and confirmed what I had been reading, that statins were great drugs capable of many positive medical results, even including preventing osteoporosis and other unrelated benefits. He said it seems that the current news on statins was the “more the merrier,” and even those not afflicted with elevated cholesterol should consider getting on the band wagon. Everyone should take one of the wonderful statin drugs.—DG

Not so much has changed regarding the PR on statins, because of the enormous monetary gains to be made from the huge numbers of people being prescribed these statins, and also because of the enormous sums of money paid to advertise them. Here are some recent headlines:

September 29, 2005 CHICAGO -- In a large study of elderly, predominately male veterans, statin use was associated with a 36 percent reduction in risk of fracture when compared with no lipid-lowering therapy, according to a study in the September 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.—Science

A study sponsored by Pfizer, reported last month, indicated that lower may be better. Plaque growth stopped in heart patients whose L.D.L. levels dropped to about 80 while it slowly continued in those with levels of about 110. Other studies are asking whether lower levels of L.D.L. lead to fewer heart attacks.--New York Times 12/2/03

Isn’t Pfizer helpful to test their OWN product?

In the latest research to show that the popular cholesterol-lowering drugs known as statins are good for more than the heart, statins are good for more than the heart, a 10-year study of more than 30,000 men shows that statins may slash the risk of advanced prostate cancer in half.—Web Md 4/18/05

It just doesn’t get any better, all this PR about the new wonder statin drugs--what's next? Statins cure bird-flu??

Too bad those two guys writing in the L.A. Times have to throw cold water on all this hot statin stuff! Who are they anyway?

JOHN ABRAMSON is the author of "Overdosed America" (Harper Collins, 2004) and a clinical instructor at Harvard Medical School. MERRILL GOOZNER is the author of "The $800 Million Pill" (University of California Press, 2004) and the director of the Integrity in Science program at the Center for Science in the Public Interest.

As my 8 year old, about-to-turn 30, daughter would say, when confronted with the obvious, which she now wants to let me know she knew—“OH WELL, THEN”—here’s the emmes:

There's no doubt that statins can help some people, especially those who already have heart disease and men at very high risk of developing it. But the scientific evidence is clear: Most heart disease results from the way we live our lives, and there's no magic pill to help us change that.So why all the brouhaha about getting so many people on statins? It's an exquisite example of bank robber Willy Sutton's law: That's where the money is.[emphasis added]--John Abramson and Merrill Goozner

No comments:

Post a Comment

Comments signed Anonymous will not be published.