Another freaking statin report

[George Mounce]

http://www.cbsnews.com/stories/2008/...n4586528.shtml

Can you believe this CRAP? MORE DRUGS FOR EVERYONE!!! The majority of comments bash CBS for even posting this junk and putting it on the morning news.

In other news, I heard the author of The Omnivore's Dilemma, Michael Pollan on public radio talking about how the country's farmers need to get back to solar based production, rather than petroleum based fertilizers and I just sat there and agreed with him. He said everyone should plant themselves a garden if they can. Luckily for me, I have an acre that is going to turn into a mini-orchard and full up veggie/fruit garden for next year.

I would suggest a pot garden (not, not the drug, the container) for everyone. Easy to maintain, easy food!

[Allen Yeh]

One concern: More people in the Crestor group saw blood-sugar levels rise or were newly diagnosed with diabetes.

Crestor also has the highest rate among statins of a rare but serious muscle problem, so there are probably safer and cheaper ways to get the same benefits, said Dr. Sidney Wolfe of the consumer group Public Citizen.

Sign me UP!


RE: Michael Pollan

In Defense of Food is a interesting book so far. I'd recommend it.

[Daniel Labuz]

I'm half-way through that book, amazing read. I especially like the part about Weston Price and how everything he achieved was blanketed by the agricultural industry and industrial times after WWII. It's sad it took us 60 years later, but we are finally unveiling this mastermind

[Grissim Connery]

Funny article. Essentially, we need to find a way to make people who think they don't need a medicine crave it.

[Arien Malec]

I actually worked on the clinical protocol used for the Crestor study, so it's interesting to see how it played out.

One thing to keep in mind is that this study had a huge sample size -- it was the largest pharmaceutical trial I've ever seen (there have been government funded epidemiological studies that are larger). Huge sample sizes are like an electron microscope -- you only use them to find significance when the difference you are looking for is small and subtle.

On the other hand, the trial was closed early, which indicates that the differences in outcomes were larger than the trial was designed to show. The trial does, apparently, show some significance in mortality (not just CV outcomes).

This was a trial looking at patients who had markers for inflamation in the absence of high LDL. Interestingly, Crestor (and perhaps statins in general, although this trial compared Crestor to another older statin) seems to do something regarding systemic inflamation, indicating that lipid lowering may not be the main beneficial effect of statin therapy in general.

The logical next question is: are there any easier, safer, and cheaper ways of lowering inflamation?

Look at this, from the diet study published in NEJM:

http://content.nejm.org/content/vol3...arge/04f4.jpeg

Look at the first graph (upper left). That's CRP, the same measure of inflamation the JUPITER study used to select patients. Dropped significantly by weight loss and dropped more in the people who cut out the crap in the low fat diet. That's probably sugar and grains, no? Seemed to drop more in the low carb group, although it didn't reach significance in this trial.

So what reduces systemic markers of inflamation better than statins? Hmm, maybe paleo eating with some extra fish oil (cut out sugar and grains, improve the omega-3 to omega-6 ratio). Perhaps some IF on top? Get some more good sleep?

[Ben Moskowitz]

Originally Posted by Arien Malec

So what reduces systemic markers of inflamation better than statins? Hmm, maybe paleo eating with some extra fish oil (cut out sugar and grains, improve the omega-3 to omega-6 ratio). Perhaps some IF on top? Get some more good sleep?

Agreed, but it can't be a bad thing that there's preventative medicine for those at intermediate risk and up for heart attack, stroke, surgery, or death. I mean, it's a 50% reduction in risk. It would be interesting to see a CRP study with righteous diet and exercise, though.

[Arien Malec]

Originally Posted by Ben Moskowitz

Agreed, but it can't be a bad thing that there's preventative medicine for those at intermediate risk and up for heart attack, stroke, surgery, or death. I mean, it's a 50% reduction in risk. It would be interesting to see a CRP study with righteous diet and exercise, though.

The absolute risk reduction is pretty small, though. This trial is, by the way, a blow to the lipid theory of CV risk, since the target population had "healthy" lipid levels. Whatever statins do, it seems to be primarily due to something else than lipid reduction.

[Mike ODonnell]

Great.....more media pushing more drugs from trials sponsored by drug companies who pay millions in ad revenue to the media......

[Scott Hanson]

Interesting take by Dr. Eades and some of his commenters over at his blog:

http://www.proteinpower.com/drmike/c.../1853/#respond

Very interesting that the title of this "unbiased" scientific study is "Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin" (JUPITER), i.e., we're starting with the "hypothesis" that we are going to justify the use, no matter what.

[Philip Stablein]

George and others, here is the NYT article by Mr. Pollan which contains the ideas from the radio talk you heard.

Apologies if this has been posted elsewhere

http://www.nytimes.com/2008/10/12/ma...2policy-t.html