If you are not confused about statins you haven’t been paying attention. Are they life saving drugs that should be given to millions more or are they pills that are largely unnecessary, if you don’t actually have heart disease, that come with a nasty range of side effects?
Recently experts who are highly critical of statins have been getting quite a lot of coverage. They point to statistics showing they aren’t worth taking, such as the finding that 140 or more people have to take them for five years for just one to benefit. That’s all confusing enough but then last week statin supporters struck back.
A widely reported trial found that most of the claimed side-effects were mistaken or illusory. It claimed there were two reasons why so many statin users think they are suffering side effects. You happen to have some problem or a pain and so, because you were taking the drug at the same time, you wrongly assumed the statin caused it. Or you had a sort of reverse placebo effect. You had read about side effects, worried you might get them and made them up for yourself. Either way the drug wasn’t guilty.
Then a senior medic Professor Sir Rory Collins came out with a strongly worded attack on the critics in the Guardian saying that raising concerns about the benefit of statins was making people “unjustifiably suspicious” of these valuable drugs. As a result some would stop taking them and some people would die. He described criticising statins as a “serious disservice to British and international medicine”.
So who to believe? Just to give an extra twist to the saga, long-term campaigner for evidence based medicine Dr Ben Goldacre who has written powerfully about the importance of not relying just on the published versions of drug trials – because of the many ways they can be manipulated – was one of the authors of the “no side-effects” study which only looked at published trials.
In his favour he did give a very useful account of the way trial results can be made to look favourable and the information you need to make a more balanced judgement.
All of this is covered on HealthinsightUK today in a post called Statin advice from the wizard of Oz. It may help to clear up some of the confusion.
Conflict of interest statement: I have been suspicious of the benefits of statins, when your risk is really low, for a long time. I think the evidence is moving my way.