There is generally unbridled enthusiasm in the medical establishment for cholesterol-reducing drugs known as statins. While they do have the ability to reduce the risk of cardiovascular events such as heart attacks and strokes, they don’t appear to reduce overall risk of death in individuals who have no history of cardiovascular disease when they start taking them (primary prevention). Also, you need to treat lots of people with statins for one person to benefit over, say, a 5-year time period. In my opinion, they just ain’t the wonderdrugs some people portray them to be.
The other side to statins, like all medication, is that taking them is not without risk. They are know, for instance, to deplete the nutrient coenzyme Q10 (CoQ10) in the body, which can lead to symptoms such as muscle fatigue and muscular pain. See here for more about this (and what to do about it).
I think one of the problems with the side-effects of statins is that there’s not enough recognition about them. One reason for that appears to be the fact that doctors are generally reluctant to entertain the notion that someone’s symptoms might be as a result of the statins they’re taking (see here for more about this). One potential problem here is that the side-effects of statins can start a long time after drug therapy is commenced. Because of this, it can be difficult for some doctors to look to statins as the potential cause of someone’s symptoms.
However, I was reading an article yesterday which suggests another reason why there is a lack of acknowledgement about the side-effects of statins: drug companies don’t want you to know about them. The article, published in the Drugs and Therapeutics Bulletin , makes the point that in February 2008, the UK Medicines and Healthcare products Regulatory Authority stated that “Following a review of clinical trial data, spontaneous reports of suspected adverse drug reactions, and published literature, product information for statins is being updated to reflect a number of different side-effects as class effects of all statins.”
Yet, getting on for two years later, these warnings have not made it into product information inserts. The folks at the Drugs and Therapeutics Bulletin have discovered why: the proposed updates regarding side-effects has been delayed throughout the European Union (EU) because “one of the innovator MA [marketing authorisation] Holders was not in agreement with this wording.”
The article goes on to say: In other words, a drug company has been able to stall the inclusion of key safety warnings. In our view, this situation is unacceptable and should be rectified quickly. The longer it persists, the bigger the impression that EU regulatory systems are more sensitive to the needs of the pharmaceutical industry than to the welfare of patients.
A couple of weeks ago I wrote a blog post which featured evidence that the adverse effects of drugs are not given the attention they deserve in terms of how trials are conducted and reported. And now it seems, even when science does turn up problems drug companies will do what they can to such information seeing the proper light of day. But, you know, who cares about the fact that people are wandering around needlessly suffering from fatigue, muscle pain, depression and impotence, as long as money is being made.
1. Uncommon Knowledge. Drug and Therapeutics Bulletin 2009;47:121; doi:10.1136/dtb.2009.10.0044
I’ve been taking statins ever since I had stents fitted ten years ago and for the last three have had Peyronie’s disease, a kind of erectile dysfunction in which the tunica sheath becomes inelastic through plaque build up with reduced length (and where this is uneven, some bizarre curvature rendering penetration impossible), mine is straight but significantly shorter with consequent unsatisfactory intercourse. GP and urologist have tried me on viagra and its alternatives with no effect – it’s not the erectile tissue that needs treatment but the surrounding tube. Options?
Perhaps indifference should be officially recognised as a chronic illness, John?
Medicine and pharmaceuticals are branches of ‘science’ that have been questioned by some for some time as having been ‘hijacked’ by the commercial agenda and what you discuss above would apparently be an example.
Due to a comparative lack of independent funding the direction of scientific research is drawn towards issues that have commercial prospects within the science and at the frontiers of ‘noble’ scientific research the derived application is likewise drawn to the commercially expedient. The status-quo is OK because politicians can leave the evolution and funding of science that they are ill-equipped to understand to experts employed by industry, ..allegedly, and they are indifferent to the counter-side of the outcomes.
At least in relation to science recognition of the problem I write upon is official. Writing in New Scientist (7th November 2009) guest authors Parkinson and Langley contribute an opinion that in science the corporate agenda is now so corrupting that we can no longer be indifferent to it; they are also leading authors of a report, Science and the Corporate Agenda, published in the name of ‘Scientists for Global Responsibility’, which attempts to quantify the problem and demonstrate the outcomes. Theirs’ is a rallying cry to scientists, many of whom are engaged in work funded by corporate finance, to recognise their contribution to a mass problem and become more ethical in what they do. In their words their report ‘exposes problems so serious that we can longer afford to be indifferent to them.’ I found a blog clearly catalysed by the article and report. Of greatest concern is that science and politics does not overlook potential low-input solutions to climate and sustainability issues.
The problem is broad but the prescriptions crisis illustrates the problem well; at least if you are prepared to consider matters with an open mind. Systemically and anthropologically low input solutions are ignored over commercially expedient ones. The aggregate of human effort is centered too far towards the process of managing or mitigating symptom sooner than establishing and eradicating cause. The treatment of atherosclerosis is a case in point and in this instance the science of the cholesterol hypothesis does not even stack up. However erroneous science prevails in the mainstream, apparently.
Just as division of labour is regarded as the foundation for economic growth so should division of knowledge be regarded as primary factorial for growth in the knowledge economy. Specialisation has brought huge advances. The draw back is that we each have to specialise and engage in labour and knowledge economies that puts bread upon our table while trusting so much to others who are equally specialised in other areas. Such trust is a dynamic of increasing risk with increasingly undesirable outcomes. This is clearly evident in the wider sense between science and and non scientist, certainly scientist and politician, but also scientists also seem to fall victim in the interdisciplinary sense.
In relation to our delivery of health care few General Practitioners seem to recognise a problem stemming from outside of their own division of the knowledge economy and for those that may, they appear disincentivised from speaking out.
Placing too much trust to the work of people who did not deserve it recently had disastrous economic consequences. It’s time to get wise.
By way of afterthought I mean it is time to get wise and for the wise to get ethical.</em