Has Professor Collins’ call for BMJ ‘statin’ papers to be retracted backfired spectacularly?

Professor Sir Rory Collins is one of the most strident advocates of statin therapy, and also leads a ‘research group’ known as the Cholesterol Treatment Trialists collaboration (CTT). Professor Collins and his colleagues hold a huge database of from statin studies, and quite-often ‘crunch the numbers’ and pronounce statins to be highly effective and very safe.

Previously, I have written about the attempts by Professor Sir Rory Collins to have two articles in the BMJ withdrawn. Both of them cast considerable doubt on the effectiveness of statins, particularly for those at relatively low risk of cardiovascular disease. However, both pieces also misquoted a piece of research finding that statins were associated with adverse effects in 17.4 per cent of those who take them. Both articles rounded this figure up to 18-20 per cent, and also implied that statins caused the adverse effects seen (the study – ‘observational’ or ‘epidemiological’ – type did not allow this inference to be made).

Once alerted to the issue, the BMJ promptly withdrew the comments about adverse effects. But Professor Collins was not happy, and insisted that the BMJ retract both articles in their entirety. However, to my knowledge, neither Professor Collins not anyone else had countered the main thrust of the articles (one was principally about the ineffectiveness of statins, and the other was the lack of association between saturated fat and heart disease).

The editor-in-chief of the BMJ – Dr Fiona Godlee – convened a committee to look into the matter, and to rule whether there were grounds for the one or both of the articles to retracted.

Elsewhere in the BMJ, one of Professor Collins’ previous collaborators – Professor Peter Sever – referred to Professor Collins’ detailed case for retraction. I emailed Professor Collins asking if I could see his detailed arguments. I was particularly interested to read what Professor Collins’ had to say about the claims that statins are, on the whole, quite ineffective. To his credit, Professor Collins replied, but only to tell me I would need to wait until the committee issued their report and all the documentation.

Well, last week, the committee published their report. It found no grounds whatsoever for retraction of either of the articles. You can read the report here, and here is a list of all the relevant documentation.

I read four (SP17-20) letters Professor Collins submitted to Fiona Godlee to make his case. Each letter, I think, has a similar theme: the claims about statins side effects were inaccurate and overblown, and as a result people may be discouraged from taking them or continuing them (exposing them to increased risk of cardiovascular disease). However, these issues had been acknowledged by the BMJ and the authors of the articles, and the statements had already been withdrawn.

However, on the subject of the effectiveness (actually, ineffectiveness) of statins, Professor Collins has nothing much to say. My guess is that Professor Collins would prefer not to engage with this critically important area, because erhaps he knows statins are extremely limited in their effectiveness in the vast majority of people who take them. Better, I suggest, to bang on and on about some other topic that maybe provides a convenient diversion.

I don’t know, but I have a sense that Professor Collins’ crusade to have the papers retracted was as much about censoring the truth about statin effectiveness as writing any wrong to do with adverse effects. And I am delighted to say he did not get away with it.

In fact, I suspect rather that Professor Collins’ ‘shock and awe’ tactics have spectacularly backfired. I think he has come across as bullying and aggressive (and wrong). But there is worse in store for him: The committee ad the editor of the BMJ have drawn our attention to the fact that the data held my Professor Collins and his colleagues at the CTT is for their eyes only. No-one else can have access to it nor is in a position to verify their conclusions about statins. In the interests of transparency and scientific integrity, they are calling for this data to be made public.

My personal opinion is that Professor Collins and some of his colleagues have done considerable damage to the reputation of medical and research fraternities. I’d say his actions will have contributed to the growing mistrust members of the public appear to have for ‘experts’. Being eminently credentialed does not guarantee that someone will always seem keen to uphold the basic tenets of good medicine and good research.

15 Responses to Has Professor Collins’ call for BMJ ‘statin’ papers to be retracted backfired spectacularly?

  1. Soul 8 August 2014 at 12:41 pm #

    Years ago i began visiting health web sights such as yours. I was looking mainly for information on improving heart health, along with having a GI condition, wanting to improve that also. (Thankfully I’ve done so.) It’s been remarkable about how much has changed over the last few years, changes that go contrary to much of what experts would teach us about improving our health. It used to be said by nearly all that the sun needed to avoided at all times. Now it is thought that some sun exposure, avoiding being burnt, can be beneficial in part due to increasing vitamin D levels. All fats were said to be unhealthy and to be limited. Now it is frequently said that saturated fats are not the villains they have been made out to be. And now we learn that high cholesterol causes heart disease was in measure a made up condition/disease. As a result, taking statin medication likely has few positive benefits, and instead a good number of negative ones. It’s troubling.

    When talk of high cholesterol not being behind heart disease was mentioned I would wonder what would come next then? What would replace the cholesterol theory? Would it be beneficial? Now, with the many health assumptions presented by experts being questioned, sometimes I wonder what comes next for our health care system? Will the current system be replaced eventually?

    Along these lines, it’s not a disease I have, but of late I’ve taken an interesting in learning more about the theory of AIDS being caused by HIV. I had read in the past that their was controversy over this theory. Some, such as Professor Peter Duesberg, had written that AIDs was an invented disease. I wanted to learn more. From what I’ve seen, there certainly is great controversy with AIDs.

    Their are a number of videos on this, with two that caught my attention yesterday being Dr. Christian Fiala’s talk and The Sunday Times London Journalist Neville Hodgkinson history presentation on how AIDs came into being. Both can be seen at:

    http://www.houseofnumbers.com/site2/video-clips.html

    if this turns out to be the case concerning the controversy, It’s tragic at how much destruction AIDs has caused for many, in the west for the countries of Africa.

  2. Stephen Rhodes 8 August 2014 at 12:54 pm #

    In answer to your article’s question, I rather think it has.

    I have posted this elsewhere but it might be better here.

    Interesting reporting of the connection between vitamin D deficiency and dementia and Alzheimer’s in the media today (yesterday 7th August).

    http://www.cholesterol-and-health.com/Vitamin-D.html was a report published in 2006 that makes the point that cholesterol is a precursor necessary for the manufacture of vitamin D in the human body and that vitamin D is found in cholesterol rich food.

    So the question for Professor Sir Rory Collins is “why are you intent on condemning so many of your fellow British subjects to a lingering mind death by destroying their limited ability to synthesise cholesterol?”

    And the question to the NHS is “why are you giving out dietary advice that will condemn many British subjects to a lingering mind death by further reducing their ability to obtain the quantities of cholesterol necessary for good mental health?”

    Statins – as many here commenting, and the author, have long protested have many side effects and this seems to be one out of left field that someone blinkered by the supposed benefits to CVD and stroke ‘candidates’ has probably not even considered.

    Maybe his feet should be held to the flame until he recognises the myriad effects of reducing cholesterol to an otherwise healthy metabolism.

  3. M. Cawdery 8 August 2014 at 6:07 pm #

    I posted the following on the BMJ Rapid Response Board. It remains to be seen if it is accepted.

    Re Stains, cholesterol and medical clinical drug research
    Following the recent controversy on SARs in the BMJ Prof Collins argues the investigation was not independent and came to the wrong conclusion.
    (BMJ ‘right’ in statins claims row. By James Gallagher Health editor, BBC News website )
    http://www.bbc.co.uk/news/health-28602155

    “He told the BBC: “It is not surprising the BMJ investigates itself and exonerates itself.
    “The BMJ published misinformation and they’ve withdrawn one major error, but have not corrected several other major errors.
    “My concern is that as before, patients and their doctors are misinformed by those papers and the BMJ’s failure to correct them.”

    “their doctors are misinformed by those papers”

    Really! and what about his own study, the HPS[1] report where there are hidden data, inaccurate reporting, etc. and massive misinformation about the value of statins? As shown by de Lorgeril,in his expose of skullduggery in clinical research on cholesterol and statins (see: de Lorgeril, Michel (2014-03-05). Cholesterol and statins: Sham science and bad medicine Kindle edition[2]) HPS at the Ultimate in Clinical Research: the Heart Protection Study Section) shows that misinformation and other flaws are present in Collins’ own research and by extrapolation all medical clinical research on Big Pharma drugs.

    The problems is now “What and who does anyone believe!” The flaws in statin research are such that it brings disrepute on the whole medical profession, the vast majority of whom are genuine hard-working docs doing their best for their patients but are being tainted by Big Pharma and their complicit medical researchers, the medical establishment and Governments with their DIRECTIVES (aka guidelines).

    Reminds me of a 150 year-old quote

    “Not only are men who are overconfident in their theories or ideas unlikely to discover anything, they are also very poor observers. Indeed, their observation will necessarily be influenced by their preconceived convictions and, when they are the instigator of an experiment, they are most likely to focus on those results that support their theory. Thus, because they do not point in the desired direction, certain essential facts are often neglected.
    Claude Bernard: Introduction à la médecine expérimentale 1865

    • M. Cawdery 8 August 2014 at 6:17 pm #

      Sorry forgot to add the references

      References:
      1. THE LANCET • Vol 360 • July 6, 2002 • http://www.thelancet.com

      2. Michel de Lorgeril (2014-03-05). Cholesterol and statins: Sham science and bad medicine. Kindle edition

      Also sent to Rapid Response BMJ

      Dr de Lorgeril’s book is particularly relevant as it demolishes the flawed Collins’ claims and indeed most of the major statin studies that falsely claim benefits for statin therapy. It is well worth acquiring and reading but very depressing as it displays the massive scam that has been foisted on patients and genuine doctors in the interests of commercial greed.

    • Clare 9 August 2014 at 2:52 am #

      as always… well said Michael.

  4. Jonathan Palmer 8 August 2014 at 6:15 pm #

    Sir Rory may well be a a man of the highest integrity but access to data is vital; otherwise you may get scientific frauds like the Sir Cyril Burt fraud on twins and intelligence where data was hidden. Keep it up Dr B

  5. Mikael 8 August 2014 at 7:11 pm #

    I see Sir Rory as the next Ancel Keys. He have no “research” backing up his claims and misinformation. As we now know that cholesterol are not the reason for cardiovascular diseases so all his argument fails. As associate Professor Ralf Sundberg confirmed at the end of last year that vegetable oils with (omega-6), sugar (fructose) and the LDL APOS B protein was the cause of cardiovascular diseases. And the hole thing that this Sir Rory seams to have no clue that cholesterol have nothing to do with ldl. Luckelly the world are now opening thier eyes and this peoples can no longer hide behind words and pretend they know. The world is catching up on them in knowledge, or on thier lack of knowledge. Good work Dr B.

  6. Paulc 8 August 2014 at 7:13 pm #

    they’re now pushing for Metformin to be prescribed as an anti-cancer drug for the over 50′s…

  7. john barr GP 9 August 2014 at 7:09 am #

    Great article, John.

    I have been following this debate with great interest, and marvel at the arrogance of the CTT people. I also marvel at the inability of the medical profession in general to pick up on any of the anti-cholesterol information out there.

    One of the young GPs that I work with noted that I told all my patients that Pro-Activ was not a good thing and wondered why, since it obviously lowered cholesterol effectively. When I told him it was not recommended in UK, and according to NICE guidelines. potentially dangerous, he was completely unaware of this. He also still subscribes, as per Australian guidelines to low fat, high carb advice for people with high lipids, and what effect that has on the various ratios.

    He was also unaware of the number of LDL sub-fractions, and how a large percentage of light fluffy molecules would be less harmful, regardless of the level of LDL. There is still no teaching of nutrition in medical courses here in Australia, and a kind of attitude that food and its quality is completely unimportant in the causation of unwellness.

    At least you are keeping up the pressure on the misinformation peddled by the drug companies and the biased factoids spouted by sanctimonious Judases like the CTT, which organisation has received vast amounts of funding from Big Pharma and other boot-licking organisations like the various Heart Foundations.

    Incidentally, while reading back through all of your articles as far as 2008, I was struck by the change in the tenor of your articles. Initially, there was just a minor noting of discrepancies in information and trial findings, but as time passed, they have become much more detailed and authoritative, and you are obviously prepared to mix it with the bully boys who just browbeat us poor GPs with “Guidelines” which have little scientific backing, far less evidence based science.

    More power to your elbow. There are a few of us GPs out there in complete agreement with you,and if recent events are anything to go by, more than a few bigwigs who would love to see the CTT forced by law to divulge everything in the complete trials information. I just hope I live that long.

    Keep up the good work

  8. Christopher Palmer 9 August 2014 at 9:42 am #

    Increasingly I think the qualities of intellect, genius, wisdom, and humility, do not stem from what a person has learned, from eminence, or from perceived credentials.

    Instead they stem from belief that what the self has learned, however extensive ones knowledge is, is never enough – for there is always something to be learned.

    Furthermore eminence is no substitute for the ability to work all available evidence into our theories- as compared say, to embracing only that which appears to confirm ill-conceived hypotheses.

    As for credentials, well, if there is one lesson to be learned from studying the fat/cholesterol hypothesis at length then it is the case that credentials may just as easily be founded upon real knowledge (truth) as aberrant consensus (half truth or outright lie). For in depth review of the fat/cholesterol hypothesis (from historical, biological, cytological, evolutionary, and physiological perspectives) reveals little in the way of reliable evidence and truths.

    Real intellect, genius, wisdom, and humility are founded as deeply in what the self does not know every bit as much as they are founded in what the self thinks it knows and perceives it can trust to be true.

    The desire to sound assured, confident, eminent, and above all without any faults or weakness in ones theories dictates suitable regard for unknown unknowns flies straight outa the window. I think this is what has happened to Rory Collins and other such pro-statin key-opinion leaders (KOLs).

    I think Rory Collins has made a serious error of judgement in the way he challenged the two papers (Abramson & Malhotra) and even moderate minded professionals who have less appreciation of the lack of evidential support for the case for lipid modification for the company here are inclined to think he overstepped the mark. Fiona Godlee and the BMJ, I am certain, will become more pro-active in the will to counter the trend to mass medicalisation of healthy people that these pro-statin KOLs advocate.

    The great irony is that a Professor of epidemiology (Collins) is one of the key influences having a positive association with the rise of mass medicalisation and over use of prescription medication that ought to be considered an ‘epidemic’ in itself. Collins is not furnished with the necessary intellect, genius, wisdom, or humility to perceive his part in driving this epidemic. The demands and requirements of the office he holds obfuscate such traits guiding his actions or commanding his perception. His eminence (and that of other KOLs) amounts to no more substance than the emperors new clothes.

  9. Ian Crowson 9 August 2014 at 12:10 pm #

    Prof. Collins, as someone whose work and studies are financially supported by Big Pharma, is perhaps only human.
    Greed for money and prestige are common human failings.
    Please keep up your good work of publishing interesting information on a range of health topics.

  10. NM 12 August 2014 at 5:42 pm #

    I posted this on another blog about the same topic, but I thought it worth repeating:

    Sir Professor Collins is inescapably corrupted. This is not to say that he wilfully and mendaciously manipulates facts and data, nor that he takes bribes, nor any other such gross malfeasance. Indeed, were he this caricature, twiddling his moustaches and cackling manically, he’d be simpler to deal with. The complexity of the truth makes it much *worse* to deal with.

    He is corrupted not by any venal, simple sociopathy, easily detected and flushed out, but via deep enculturation. And that systemic infection is much, much harder to expose and disinfect than a single bad apple in an otherwise fresh barrel. He floats in a malignant meme-pool, and it’s not surprising that his whole worldview, his perception of truth and his opinions of those who dare disagree, be discoloured by that murky meme-pool. The pool in question is filled with a number of dark, unprobed, a-priori assumptions, all of which conveniently and “coincidentally” bolster the pharmaco-industrial status quo. Some of these memes derive directly and obviously from his funding sources. After all, they expect a return on their 300 million investment. Other assumptions derive from subtler patriarchal privileges. And a more innocent remnant can be seen as a genuine, if metastasised, desire to defend Enlightenment values against barbarism and dark superstition.

    So, it’s not surprising that a man who has spent his whole life literally institutionalised should react like this to those who question both him and the very bases of his institution. Indeed, to try to separate man from institution in this instance is hopeless: it’s like asking “what is the cell – the mitochondrion or the nucleus”? So, he barks angrily not only out of anger, but incomprehension. An attack on his institution is an attack on him. And vice versa. Towered-ivory myopia is a wondrous malaise. His institution prizes a reductionist world-view, distilled into the “sell-a-pill” sine-qua-non notion of medicine so familiar to us all. Any deviation from this word-view, to Sir Professor, is a suspicious deviancy by Dark-Age infective agents.

    Furthermore, his institutions and those in its orbit prize hierarchies and status beyond mere coin. The members of those institutions are keen gatekeepers to “proper” knowledge, to status, and to their own more primal self-interests equally. And so they guard those gates as vehemently as any doberman.

    Unfortunately for Sir Professor, the proliferation of the Internet has empowered independent researchers competently to partake in scientific analysis beyond those gates, despite the best intents of the gate keepers. This means that he must suffer impudent little barbarians – like you and me and everyone else here – who nip at his mighty heels and defy his haughty edicts, no matter how loudly he barks back. It must be very confusing for him, suddenly to have his citation-circle intruded upon by such “unwelcome externalities”.

    It almost makes one feel sorry for the old dog. Until one remembers, again, the 300 mil or so his organisation pockets from organised crime*

    * Before Sir Professor should sue in outrage at my painting his paymasters thus, he should note that I’m merely quoting nobel laureate Peter Gøtzsche here!

    • William L. Wilson, M.D. 17 August 2014 at 10:34 pm #

      I agree the Gotzsche’s book “Deadly Medicines and Organized Crime” is a real eye opener.

  11. Brian Williams 21 August 2014 at 10:35 am #

    The McGovern report – fats vs carbs based on Ancel Keys’ junk science meant a huge windfall for Big Green (high fructose corn syrup – “value added” carb products) and Big Pharm (statins, drugs for obesity related disease, IBS, Crohn’s, Coeliac, Cancer) and of course Big Medicine (Bariatric Surgery, Oncology, Cardiac)

    Does this remind anyone of the huge profits being made by Big Green by taxing our use of fuel, closing down coal power stations, scattering ineffective wind turbines and solar farms everywhere at taxpayers subsidy expense? Looked at your energy bills lately?

    The Saturated Fats theory and the Global Warming theory are the two biggest scams of the 20th Century.

    Follow the money.

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