Med journals in statins safety row
Confusion for users of cholesterol-lowering drug
PATIENTS on statins were plunged deeper into confusion this week when the UK’s two leading medical journals went to war over the safety of the drug.
The row was triggered by a review in The Lancet last week that concluded the pills were safe and their benefits far outweighed any harm.
It was the biggest review into their use, but rival journal The BMJ has cast doubt on the assertions by claiming “adverse” side effects are more common than it implied.
It also urged the UK’s chief medical officer Sally Davies to intervene by launching an independent inquiry.
Health campaigners said most patients would be left “utterly confused” and would not have the “vaguest idea what to believe”.
Professor Rory Collins, lead author of the Lancet review undertaken by a team of Oxford researchers, concluded the pills were so beneficial that 6 million more adults should be taking them.
The Lancet’s editor, Richard Horton, also launched an attack on research published in The BMJ that 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 this week The BMJ defended this research and questioned The Lancet’s claims that the pills are safe and effective.
Writing for the journal, Dr Richard Lehman, a retired GP and Oxford University academic, said muscle pain and fatigue were “prevalent” and “recurrent” in many patients on statins. And Professor Harlan Krumholz, a cardiologist at Yale University in the US, said many scientists still had “persistent concerns”. Also writing for the journal, he added there was a “lack of good evidence” for the pills’ benefits in elderly patients.
Fiona Godlee, The BMJ’s editor, has written to Davies 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”.
The UK Department of Health said Davies had only just received the letter and had not yet decided whether to carry out a review.
Health experts urged the two journals to resolve their differences so they could work together to uncover the truth about statins. Tam Fry, of the National Obesity Forum, said: “I find it unbelievable that the medical establishment should be at loggerheads over whether they are worthwhile or not.
“Poor Joe Public doesn’t have the vaguest idea about who to believe. It is essential someone in authority declares one way or the other what the truth is on statins. Until that day we are going to have people putting themselves at risk.”
Statins lower levels of bad cholesterol in the blood and prevent the build-up of fatty deposits in blood vessels, reducing a patient’s risk of a heart attack or stroke.
But they can cause unpleasant and potentially fatal side effects including muscle pain, tiredness, type two diabetes and blood clots in the brain. Some scientists and doctors say drug firms have downplayed these harms and exaggerated their benefits.
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.
The Lancet is considered to have more influence than The BMJ among academics.
The authors of last week’s review calculated that out of 10 000 patients taking statins, only 10 to 20 a year would suffer side effects. In the same 10 000, they would prevent 1 000 heart attacks or strokes.
A spokesman for The Lancet declined to comment. – Daily Mail