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Lancet and BMJ at loggerheads over safety of statins

sarah darwins

Senior Member
Messages
2,508
Location
Cornwall, UK
Horton says a recent Lancet published review shows statins are effectively safe and contradicts earlier BMJ published research suggesting risks were understated.

BMJ editor Fiona Godlee disagrees and calls for an 'independent' review.

Who to trust?

http://www.dailymail.co.uk/health/a...-rival-medical-journal-says-ve-got-wrong.html

An independent review?! :eek: I say, steady on. That's not how we do things in England, young lady. Sounds like a bit of a troublemaker, that one.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
The Daily Mail website is a mind-bendingly annoying site to load, with ads and stories about which celebs have been revealing which body parts popping up all the time, making it impossible to navigate and making my browser crash (possibly in shock).

The highlights of the article for me:


The BMJ has cast doubt on the assertions by claiming ‘adverse’ side effects are far more common than the study implied. It also urged the chief medical officer Dame Sally Davies to intervene by launching an independent inquiry.

Professor Rory Collins, lead author of the Lancet review undertaken by a team of Oxford researchers, concluded the pills were so beneficial that six million more adults should be taking them.

The Lancet’s editor, Richard Horton, also launched a strong attack on research published in The BMJ that had warned of the possible side effects of the pills. He said two studies that had appeared in the journal in 2013 resulted in 200,000 patients stopping their statins, potentially harming their health.

But last night The BMJ defended this research and questioned The Lancet’s claims that the pills are safe and effective. Fiona Godlee, The BMJ’s editor, has written to Dame Sally urging her to launch an inquiry into statins. She said an independent review of their safety and effectiveness ‘remains an essential next step if this increasingly bitter and unproductive dispute is to be resolved’.

Concerns have also been raised that many of the academics promoting their benefits are being funded by the pills’ manufacturers. These include Professor Collins and the two other academics involved in last week’s review, whose past research had been paid for by drug firms making statins.

A spokesman for The Lancet declined to comment.

Who to trust?

If you rephrase that question as "who not to trust?" it becomes a no-brainer. Looks like business as usual at the Lancet.

An independent review?! :eek: I say, steady on. That's not how we do things in England, young lady.

Apparently it's ok as long as the person you ask to do the review is a dame.
 

TiredSam

The wise nematode hibernates
Messages
2,677
Location
Germany
From the BMJ:

http://www.bmj.com/content/354/bmj.i4992

Commenting in The BMJ this week, Harlan Krumholz agrees on the strong case for the overall benefits of statins, but he wants more acknowledgment of the trials’ limitations (doi:10.1136/bmj.i4963). These include the lack of good evidence in elderly people, the variation in how adverse event data were collected, and the ageing of the trials themselves.

This week we publish documents (http://static.www.bmj.com/sites/default/files/copedocuments.pdf) that serve to correct Richard Horton’s comments in the Lancet (doi:10.1016/S0140-6736(16)31583-5), in which he wrongly stated that COPE had “declined to act” on Collins’s concerns. (See also my rapid response www.bmj.com/content/351/bmj.h3908/rr-8.)
Independent third party scrutiny of the statins trial data remains an essential next step if this increasingly bitter and unproductive dispute is to be resolved. I have now written to England’s chief medical officer, Sally Davies, asking her to call for and fund an independent review of the evidence on statins.

As Krumholz concludes, sharing the individual patient level data from the statins trials would send “a strong message that no single person or group should have exclusive access to data” that are so important for public health.

So many parallels here - a trial with limitations, Richard Horton sticking up for his mates with links to industry and either making statements that are incorrect or remaining silent, the need for third party scrutiny of the trial data ...

Criticism of the Lancet on the same issues that have affected us for so long can only be good for us, and maybe the issue of statins, which 6 million people take in the UK, is big enough for people outside the ME community to start giving a toss about the disgraceful practices of this scandalous rag.
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
Trust neither. Trust the long term scientific process ... if there are questions its still controversial. One thing I would want to know, and this is for each drug, not class of drug, is the long term survival rate from all causes, which requires ongoing epidemiological studies.

The Lancet reputation is an issue, but we cannot use that to compare individual studies without considering, first and foremost, the details of those studies.
 

SilverbladeTE

Senior Member
Messages
3,043
Location
Somewhere near Glasgow, Scotland
Statins were pushed as a "wonder drug", like so many others before them...for profit
FIRST DO NO HARM, is the prime rule of a physician, you treat a patient when there is actual cause, not because you think a drug will "help when they are well"

EVERY drug is a poison, it's always a matter of dose and effects over time, even "safe" drugs over a long time nearly always have some serious risk/problem, that's the simple truth
the point is "does the benefit outweigh the risk?"

For example, painkillers have lots of issues, depending on type, but, they make quality of life bearable and that is vital.
If my life expectancy is lowered a few years by their use, that's an acceptable trade, and one people should be honest about.

Being obese, sedentary, high blood pressure etc, statins could well help, but, for the average person....never wise to take rugs without reason. Everyone is different, every person has a chance for severe reaction to *any* drug
Pushing these drugs was always about money.
 

Skippa

Anti-BS
Messages
841
So effective and safe that 6 million more patients should take them...

Hmmmmm...

Big hmmmmmm

Lots of pockets, and fingers, and pies, and slices of cake... All pigs in a trough at the end of it though...

Has a single statin ever been shown to save a single life?

I seem to remember Ben Goldacre himself going on about the dubiosuness of statin pushers...
 

Hip

Senior Member
Messages
17,799
The Daily Mail website is a mind-bendingly annoying site to load, with ads and stories about which celebs have been revealing which body parts popping up all the time, making it impossible to navigate and making my browser crash (possibly in shock).

I hate the Daily Mail website information overload too.

If you use the free AdBlock ad blocking extension in your browser, then the following lines of code (in the blue box below) added to your AbBlock filter list will remove all of the ads and other celebrity crap that the Daily Mail serves up, making page loading faster, and enabling you to read the main story without causing a cerebral hemorrhage to yourself!

The AbBlock filter list is located under Adblock > Options > Customize > Edit Your Filters.
Code:
www.dailymail.co.uk##DIV[id="infinite-list"][class="item news"]
www.dailymail.co.uk##DIV[class="beta"]
www.dailymail.co.uk##DIV[id="most-watched-videos"]
www.dailymail.co.uk##DIV[class="rotator news"]


I like Adblock, as it allows you to block out any section of a webpage, not just adverts (to block out a section of a page, just right click on the webpage, and hover over the section you want to block, then left click it). Adblock is available for Safari and Chrome, but not Firefox (as far as I am aware). Not to be confused with Adblock Plus, a different product.
 
Last edited:
Messages
724
Location
Yorkshire, England
O/T @TiredSam, @Hip, you have inspired me to start a thread about making places like the Daily Mail more readable. http://forums.phoenixrising.me/inde...our-internet-experience-less-stressful.46850/

There is a good blog on BMJ about this, http://blogs.bmj.com/bmj/2016/09/12/richard-lehman-where-next-with-statins/ a few points raised

The harms of statins are generally mild and reversible. But muscle pain and fatigability are not a figment of misattribution and public misinformation. They are too prevalent and recurrent in people who desperately want to stay on statins. Rather than discount a widely observed phenomenon, we should ask why there is such a mismatch with reporting in the trials. There is an urgent need for studies in the elderly, to test the hypothesis that their borderline daily functioning may be impaired by statins, tipping people into deconditioning and dependency.
(empasis added)
The main adverse effect of statins is to induce arrogance in their proponents. The evidence for this class of drugs is massive and the areas of controversy are quite small. Most of the current debate consists of throwing blame at The BMJ for creating public doubt about statins in two short articles. So it has become an argument about communicating evidence to the public and to individuals, and this is something the Lancet authors seem to think should be done by authoritative persuasion based on numbers-needed-to-treat. In fact the NNTs for statins are generally much too large to be persuasive for individuals, and they are in any case not evenly distributed across individuals. Nobody has devised the ideal decision tool, partly because we are only just beginning to take account of how human beings actually react to different kinds of risk framing.
(empasis added)