I posted a few days ago about the results of a very concerning meta-analysis (lumping of data from several trials together) suggesting that high dose of cholesterol medicines increase the risk of cancer. This is a huge public health issue which major repercussions for big pharma.
There has been extremely little coverage of this in any of the main stream media. I can't figure out why.
The statin drugs are collectively about a $15 billion dollar market in the US and also have significant sales abroad. They clearly decrease the risk of heart attacks and strokes and are important for patients with high risk of heart disease.
Their use has been very widespread. Thanks partially to direct to consumer ads, there is a huge population on statins- some who are at low or intermediate risk for cardiac events.
In these populations (a large portion of the overall group), this new study will require us to rethink statin dosage and usage.
This is important stuff. Much more so than the Avandia news (which was also from a meta-analysis, but a much smaller data set) which dominated the news for several days a few weeks ago. But, this is news no one has heard. None of my colleagues was aware of the study when I asked yesterday and the Lipitor rep I discussed it with told me that they hadn’t yet been fully briefed on the situation and that no other doctor had asked her about it.
How could this major finding have passed unnoticed? There has been no mention in the WSJ or NY Times and only minimal TV coverage. The trial that the Journal of the American College of Cardiology agonized over publishing for weeks over fears that it would cause panic is apparently less important than some study about diet soft drinks!?!?! I suspect that this speaks more to the huge power of the drug companies. I can only assume that they have leaned on the major news outlets not to discuss this data for fear of causing a major panic. Or maybe this is just cancer fatigue- with news of so many things potentially causing some cancer or other, people seem to have stopped caring.
Comments
Anonymous
July 27, 2007
Why hasn't this been reported?
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Anonymous
July 27, 2007
It is hard to evaluate this report. The reported increase of .1% in the incidence of cancer could just be some sort of covariable. E.g., the incidence of cancer increases with age and pateints on statins live longer. Similarly, perhaps the same pathogenic process that leads to use of higher-dose statins also is involved a little in carcingenesis.
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Anonymous
July 31, 2007
An interesting side story:
Studies are showing that Vitamin D is a cheaper, safer alternative to statins.
Vitamin D deficiency is epidemic since we've become so afraid of the sun. Deficiency has been linked in many reliable studies to cancer, obesity, hypertension, diabetes, cholesterol, MS and the list goes on.
Vitamin D has been in the news quite a bit lately and I think when the public finally realizes its full importance, Big Pharma is going to take a big hit. Supplements are under attack, but you can't make sunshine illegal.
http://www.vitamindcouncil.com/research.shtml
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=16815382&dopt=AbstractPlus
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Statins
August 04, 2007
There have been hundreds of studies done. All showed that the lower the LDL the better. But how low is to low? People on high dose statins, usually have other comorbid diesease states, like obesity, a direct link to cancer risk. Give me some hard numbers.
By the way, the media is at war with the pharma industry in case you haven't noticed. So if more docs thought this was true, it would be a MAJOR headline.
Sorry...you lose!!
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scooter
August 16, 2007
Pharmaking is absolutely right. It fits right into the "epidemiological association of questionably scientific merit" mold that usually makes for great primetime "health news" reporting. That it wasn't widely reported begs all sorts of conspiracy theories.
The wording of the abstract is surprisingly grave if one parses it carefully. I have a considerably more sanguine interpretation of all this. The kind of statistical fine-tuning used to demonstrate a correlation here:
"...significant inverse association between cancer incidence and achieved LDL-C levels, whereas no such association was demonstrated with percent LDL-C reduction or absolute LDL-C reduction..."
always makes me question the fundamental scientific validity of the reported association. "Achieved" LDL levels likely reflect much more the underlying patient physiology, which could be linked to cancer propensity independently of statin use, compared to LDL "reduction," which presumably is more closely related to pharmacodynamics.
Nonetheless, the language used in the JACC is compelling for primary providers, who may need to rethink the low threshold some of them have for pulling the trigger on the use of statins in low-risk patients.
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