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Statins harms exaggerated, benefits underestimated, major Lancet Journal review shows

ABC Catalyst’s statins program – presented by Maryanne Demasi – was found to have breached the broadcaster’s editorial standards. Photo: ABC The numbers of people who avoid heart attacks and strokes by taking statin therapy are very much larger than the numbers who have side effects, the review’s authors said. Photo: AFR

Misleading reports warning patients off taking their statins have exaggerated their harms and underestimated their benefits, a major review says.

Claims that the cholesterol-busting drugs cause high rates of serious side effects had dealt a “serious cost to public health”, and had convinced some patients to stop taking their medication, the scientists in the Lancet-published review said.

In a move the review’s authors hope will put an end to the notion that statins cause more harm than do good, the research published Friday outlined the plethora of evidence collected over the past 30 years that backed their efficacy.

“Our review shows that the numbers of people who avoid heart attacks and strokes by taking statin therapy are very much larger than the numbers who have side effects,” said Professor Rory Collins at the Clinical Trial Service Unit at Britain’s Oxford University.

Patients who experience side effects – which include muscle pain, nausea and liver problems – could reverse them by stopping the statin, while the effects of a heart attack or stroke “are irreversible and can be devastating”, Professor Collins said.

Periods of intense public discussion about statins were followed by rises in the proportion of people who stop taking the drugs, and by falls in the number of prescriptions for them, the authors wrote.

The stoush erupted in 2013 after papers published in the British Medical Journal claimed up to 20 per cent of users get side effects. The 20 per cent figure was later retracted after the BMJ said it was based on flawed data, but this and other reports affected patient confidence.

In Australia, a two-part series on ABC’s Catalyst that aired in October 2013 was found to have violated the broadcaster’s standards and was removed from its website.

Presented by Dr Maryanne Demasi, the program claimed the causal link between saturated fat, cholesterol and heart disease was “the biggest myth in medical history” and cholesterol medications, known as statins, were toxic and potentially deadly.

A large numbers of people stopped taking statins without consulting their doctors after watching the  program in 2013, a GP survey found.

Lancet editor Richard Horton compared the harm of statins misinformation to that of the notorious – now discredited – research paper that linked the measles, mumps and rubella vaccine to autism.

“We learned lessons from that episode and those lessons need to be widely promulgated. They are lessons for all journals and all scientists,” Dr Horton said, whose journal had originally published the MMR paper.

Once among the biggest revenue generators for drugmakers such as Pfizer and AstraZeneca, most statins are now off-patent and available as cheap generics.

Cardiovascular disease accounts for an estimated 31 per cent of all deaths and claims 17.5 million lives a year worldwide, according to the World Health Organisation.

Associate Professor David Sullivan at the University of Sydney’s Central Clinical School said the review was “wonderful news” and restored a balanced perception of statin therapy.

“The review establishes that statins prevent large numbers of fatal or serious irreversible heart attacks and strokes with very little in the way of side-effects, Associate Professor Sullivan said.

He said the treatment, which would prevent 500 to 1000 such events per 10,000 patients, would only result in a handful of serious muscle problems, most of which would be reversible.

Monash University Emeritus Professor of Medicine Mark Wahlqvist said the review did not canvass the reasons the billion-dollar statin industry was needed to begin with, and the need for head-to-head studies that considered environmental, personal and socio-economic factors of cardiovascular disease.

“This population-wide risk is a serious omission from the Lancet report. Without these caveats, the next we will learn is that we are all expected to take statins from a younger and younger (and older and older) age, irrespective of our food culture, personal behaviours and medical history. Let’s know for whom the statin bell tolls,” Professor Wahlqvist said.

With Reuters

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