Statin - No Longer an Island

[tobagotwo]

Oh, here goes Bob, statin-bashing again… (And, yes, I know that's not how Staten Island is spelled.)

I was led to a press release by http://www.hbsslaw.com/press_release_Lipitor.htm about an article in January 20th issue of The Lancet, the famous British Medical Journal.

Excerpts:

Article in The Lancet Claims Lipitor ® Is Over-Prescribed to Millions of Americans. Award-winning physician John Abramson argues that clinical trials provide no evidence of lowering cholesterol in women and elderly. January 22, 2007

The article…shows that clinical trials for coronary heart disease prevention fail to prove that anti-cholesterol drugs, such as Lipitor, provide benefit for many in the U.S. who are taking them.

Dr. Abramson and co-author Dr. Jim Wright of the Therapeutics Initiative in British Columbia say that statins, a class of cholesterol-lowering drugs, should not be prescribed for the primary prevention of heart disease to women of all ages or to men older than 69 years of age.

According to Abramson, the article titled "Are Lipid-Lowering Guidelines Evidence-Based?" shows that no studies have shown statin drugs to be effective for women and men 69 years of age or older who do not already have heart disease or diabetes.

…the 2001 National Cholesterol Education Program (NCEP) guidelines significantly increased the number of Americans for whom statins were recommended. The number jumped from 13 million to more than 36 million Americans, with most of the additional 23 million for whom statins were recommended yet to develop coronary heart disease.

"…the truth is the guidelines exaggerate the benefits of statins for many people who don't yet have heart disease. " said Abramson. "Millions of Americans are taking statin drugs like Lipitor without any clinical proof that they're beneficial to disease prevention, or any other benefit to their overall health."

In September 2005, a class-action lawsuit was filed against Pfizer, the maker of Lipitor, alleging that Pfizer engaged in a massive campaign to convince both doctors and patients that Lipitor is a beneficial treatment for nearly everyone with elevated cholesterol, even though no studies have shown it to be effective for women and those over 65 years of age who do not already have heart disease or diabetes.

… John Abramson, M.D. serves as a clinical instructor of ambulatory care at Harvard Medical School

More information about the nature of the class action lawsuit now in play against Pfizer, and about some of the studies referenced by it is available at http://www.hbsslaw.com/frontend?com...ssReleasePrintableDetail&iPressReleaseId=1020

As you know, I am lukewarm about statins at best, and have argued against what I see as overprescribing, unsupported inuendo campaigns among physicians to support off-label prescriptions, and the exploitation of the public through fear of heart disease to push patients into accepting prescriptions for statin drugs.

I see this article and lawsuit with a sigh of relief. If I'm crazy, I'm not alone.

Best wishes,

 

[Phyllis]

Thanks for posting this Bob- scary isn't it? I had trouble with Lipitor and higher doses of Pravachol and am now on the lowest dose of Pravachol and Zetia- cholesterol is in control, but this really makes me wonder -again! At Dick's last doctor's appt. the cholesterol was slightly elevated and the doctor insisted he go on the lowest dose of Zocor and you may remember how greatly his cholesterol was reduced on Zocor right after surgery when it was suggested by the surgeon to reduce chances of calcification of the new valve. At the time of surgery his arteries were clean as a whistle. His numbers dropped so extremely low that it scared us and we took him off it of our own volition. Can my aches and pains be a result of the Pravachol or just old age- I need to discuss this with my doctor when I get home again in April assuming Pfizer has not just taken her out to lunch or paid for a vacation.

 

[Rich]

Good article Bob

Good article Bob

After seeing my wife's reaction to statin drugs (and she has tried them all), this doesn't surprise me a bit. When a very active lady could no longer even stand up let alone walk, it was time to dump that stuff. Now she is on Zetia along with some natural medications. This coupled with diet and exercise has been working fine. I still am taken back by the ads for these statins, such as unexplained muscle pain and weakness. As I have stated before the heart IS A MUSCLE !!
I am almost convinced that the much lower numbers for cholesterol ranges these days were created to sell millions more pills.
And as you may have heard Pfizer is doing some drastic downsizing. They are closing a plant right here in the Metro Detroit area, two thousand people will lose their jobs. But as Jay Leno said the other night the good news for Pfizer is they will probably have two thousand more customers for their anti-depressant medication.
Rich

 

[tobagotwo]

The highlights are deeply significant.

The largest study of Lipitor in women showed no change in their risk of heart attack, despite lowering cholesterol levels.

This part should be read carefully. Their wording is clumsy. There are two statements.

One statement is that no studies have shown statin drugs to effective for women. Period. All women.

The second comes in two flavors: no studies have shown statin drugs to be effective for men 69 years of age or older who do not already have heart disease or diabetes, or no studies have shown it to be effective for those over 65 years of age who do not already have heart disease or diabetes.

It culminates in this cardioblasphemy: a recommendation that statins, a class of cholesterol-lowering drugs, should not be prescribed for the primary prevention of heart disease to women of all ages or to men older than 69 years of age who don't already have heart disease.

Pretty straightforward.


Best wishes,

 

[ShezaGirlie]

Grrrrrrrrrrrrrrrr

Grrrrrrrrrrrrrrrr

And my mama's doctor put her on Lipitor just last year. Folks, my mama is 91 years old and made it to age 90 without Lipitor. So, don't go telling me that Lipitor is gonna extend her life...or that she has clogged arteries. She's healthy as a horse and still lives alone in her house on the ranch.

Yep, it's all about those gourmet lunches being delivered to doctors' offices.

 

[BackDoc]

I see patients every week who enter my office complaining of muscle and joint aches and pains, and upon examination they have no physical problem that I can determine. The common factor is the statin drugs they are on. I send them back to their PCP's and if their PCP's are intellectually honest, they'll reduce the dose or switch to another drug--funny how the pain rapidly subsides.

Two things that anyone can add to their diet that will elevate the good HDL, as well as reduce the bad LDL's, with no side effects are; fish oil and flax meal. One teaspoon of liquid fish oil and two tablespoons of flax meal a day can decrease LDL by up to 15%. The fish oil will raise HDL levels.

Few if any doctors will make these recommendations. Why? Because the fish oil and flax salesman aren't buying the office lunch on a weekly basis.

However, caution is advised regarding fish oil with cumadin. The fish oil should not effect INR values, but it can can in certain instances result in a slightly increased bleeding time.

Excellent thread!

 

[hensylee]

dr wanted me to try another pill a couple momths ago. It was a statin with something else. I tried it fror 3 days - muscle weakness - I quit. Back to Zetia.

Afrter Lipitor, I am really gunshy. Still have trouble walking - like Rich's wife.

 

[sue943]

So what are you saying, are you saying to take simvastatin (ZOCOR) is not a good thing? I have been taking it for about twenty years, first a low dose then a higher one. I thought this was to try to prevent possible problems as there was a family history (mostly with the men) of coronary thrombosis.

 

[Phyllis]

Stopped taking my Pravachol last night- just taking the Zetia. I will have blood work when I get home at the end of April- will be interesting to see if the Zetia alone has held down the numbers and how much hell I will catch from my doctor. Also interested to see if my legs have more stamina after a month or so with no Pravachol.

 

[tobagotwo]

Sue,

This is not about what I say. This is about an article by a Harvard Medical School instructor about what the studies of statin use have shown.

I have my opinions about it, but I am not a medical professional. I do know that statins don't hurt everyone. I do know that they do hurt some people. I also know that statins don't help everyone. This article says they probably don't help large groups of people who are receiving them.

I suggest that you read the information in the links, and look some more on your own, with "new eyes" as the comedian Gallagher used to say, and that you discuss it again with your doctor if you decide you need to reconsider your medications, once you've had a chance to determine how you feel about it.

I do not advise anyone to use this as a reason to simply stop using statins. It's a discussion you should have with your doctor as well as yourself. As with all medical treatments, it's your choice in the end, but you should be availing yourself of all reasonable sources of advice before making any medical decision, even for yourself.

All right, I can't resist...I just have to say that my personal opinion is that putting ShezaGirlie's 91-year-old mother on statins at age 90 just defies all reason.

Best wishes,

 

[Phyllis]

I

do not advise anyone to use this as a reason to simply stop using statins. It's a discussion you should have with your doctor as well as yourself. As with all medical treatments, it's your choice in the end, but you should be availing youself of all reasonable sources of advice before making any medical decision, even for yourself.

Bob,
Please do not feel that you have anything to do with my stopping the Pravachol. Based on my past history with Lipitor and a higher dose of Pravachol, this is an action I have been considering for some time. I have read all the links and they just reinforce my own opinion. If I were home, I would discuss it with the doctor first, but since I am not and am having blood work done when I get home, I feel this is an opportunity to see if the Zetia works on its own. - that will make for a stronger argument. Considering the fact that I have no heart problems - yet, I feel confident in making this decision.
Best wishes,
Phyllis
P.S. and I agree about ShezaGirlie's mother- kind of like my late father-in-law worrying about having a bowl of ice-cream when he was 101!

 

[Susan BAV]

I have a question that maybe you could answer, Bob? Shortly after my AVR I went into A-fib and digoxen didn't take care of it so I was rehospitalized and put on Sotalol (sp?). About one week after beginning that medication, I suddenly began a bad pain where my left leg attaches to my torso (not the angiogram side) and it became much worse very quickly where I could hardly walk the next day -- it was absolutely horrible pain and I do not use that description lightly. The pain was also in the other side but much slighter. It took a full year for that horrible pain to gradually and then finally subside. I always figured it was caused by the Sotalol. I don't believe or recall if I discussed it with my doctor though. (edit here - Mr. "W" reminds me that I did mention it to cardio) Have you, in your research, ever stumbled across any information [like this] about Sotalol? I was also on Coumadin then, both meds for three months, and I had just received several magnesium IV's when I had been rehospitalized also. Do you have any ideas? Thanks.

 

[tobagotwo]

Phyllis,

You've been here for a long time, and it's always been plain to me that you wouldn't do something rash like that. You're a researcher, and I understood it that you had already made that decision on your own some time ago, based on other, similar information you had already found.

There may be people who find that this information leads them to investigate more, and may eventually decide to go off of statins due to evidence they find compelling, and that would be fine. I'm just saying that like valve choice, in medications each person must find his or her own way. And that means understanding the issues and your own body.

Best wishes,

 

[Magic8Ball]

I asked a question in the post surgery section about statin but will re-ask it here....

I've just been prescribed lipitor (low dose) because the cardio wants to decrease my cholesterol by nearly 50%....i had read threads like this and asked him about the alternatives but he said they wouldn't reduce it by enough (quoted me figures between 5 & 25 % for the others) and that i'd have to try this first before he could authorise using any other drug, he's been good prior getting me onto coversyl so i trust that he would put me straight onto the other if he could.

I'm a 37 year old male so i don't fall into the category that this drug is no use for me so i can only hope i don't have a reaction to it....the cardio said it was a 1 in 200 case of bad reactions to it.

But how would i tell, my body is busted from years of contact sports so currently i have a tight painful calf, tight hamstrings, sore lower back, sore back between the shoulder blades and i havent even taken one of the lipitor tablets yet

My recovery has been great and i'm going back to work in about two weeks so i'm just nervous about screwing it all up by taking this statin based drug.

Any thoughts from those currently using the stuff?

 

[jeffp]

Now, now....one study does not a medical fact make. Nor two, or three.

Fortunately, the pharmaceutical industry has dozens, if not hundreds, of studies sitting in a drawer somewhere, ready to pull out just in case of things like this. Then there's always "experts on call" to dispute or discredit those who disagree with the powers that be.

I'd like to hang around a bit longer and continue to be sarcastic, but I've got to take my statins and meet my pharmaceutical sales rep for a complimentary lunch.

 

[Susan BAV]

I have a question that maybe you could answer, Bob? Shortly after my AVR I went into A-fib and digoxen didn't take care of it so I was rehospitalized and put on Sotalol (sp?). About one week after beginning that medication, I suddenly began a bad pain where my left leg attaches to my torso (not the angiogram side) and it became much worse very quickly where I could hardly walk the next day -- it was absolutely horrible pain and I do not use that description lightly. The pain was also in the other side but much slighter. It took a full year for that horrible pain to gradually and then finally subside. I always figured it was caused by the Sotalol. I don't believe or recall if I discussed it with my doctor though. Have you, in your research, ever stumbled across any information [like this] about Sotalol? I was also on Coumadin then, both meds for three months, and I had just received several magnesium IV's when I had been rehospitalized also. Do you have any ideas? Thanks.

I found an answer to my question on a Sotalol/Betapace informational page. "Sudden leg pain. Seek immediate medical attention." H-m-m-m. Well, I'll know next time.

I also stumbled across something else that was rather interesting on another Betapace informational page which I have cut and pasted here:

Anesthesia
The management of patients undergoing major surgery who are being treated with beta-blockers is controversial. Protracted severe hypotension and difficulty in restoring and maintaining normal cardiac rhythm after anesthesia have been reported in patients receiving beta-blockers.

This certainly doesn't fit exactly with the statin drug information of this thread but it has been wondered about many times, namely, why some valvers develop A-fib after OHS. I had been put on beta blockers a few months before my AVR. I developed A-fib post-OHS (which was why I was put on Sotalol, which is why I evidently had the horrible leg pain, which is why I wondered about any connection between statin muscle pain and possible Sotalol leg pain and posted on this and other threads about statins).

Perhaps now I have my answer! Two answers actually. Now if I can just remember them!

Anyway -- DO MEDS SOLVE OR CAUSE MORE PROBLEMS?!?

 

[Phyllis]

Susan- every med has an action and a reaction and it's sometimes hard to figure which med is doing what when we take more than one. Glad you got to the bottom of this! As always, we are our own best advocates.

 

[Dennis S]

Example

Example

I think I am the perfect example of the over-prescription you mention. A day prior to my bi-leaflet AVR surgery they did the normal procedure to see if my arteries were in good shape. (I have forgotten the name of the procedure). I was told I had "the arteries" of a teenager-perfectly clear. Seven days later, as I was being discharged from the hospital the cardiologist sent his head honcho over to sign me up for Lipitor. I was not in the mood for such nonsense, and was probably "overly clear" in explaining what a dumb idea that was. At that moment in time no one in the country was a less likely candidate to need Lipitor (in my laymen's opinion).

She offered to go get the Dr., I declined. I have come to firmly believe that blind faith in your Dr. can get you killed. They are necessary, and can be very helpful-but you better get yourself in the best possible position to evaluate their advice.

 

[PJmomrunner]

This thread and my subsequent investigations into lawsuits against Pfizer because of Lipitor have really piqued my interest. My dad has been on ever increasing doses of Lipitor (or some other statin) for at least ten years. He currently takes 80 mg. a day. In the last three to five years (I'm going on my memory of past conversations in which I was not seeking to make any connections, so I'm not sure about the exact timeframe) he has complained of a burning sensation on the bottoms of his feet. He has been prescribed a number of different medications to help with this and none works (as well as the Absorbine Jr. someone told him to try ). He has also, in the past two years, begun complaining of memory lapses. He was always the one with the great memory, but he has just chalked it up to old age (74). It turns out both these symptoms have been cited in a recent lawsuit.

My dad hesitates to talk to his doctor about trying another drug because of the uncertainty of the cost of, say, Zetia versus Lipitor.

It is easy enough to compare the cost of the two on various websites, but what is a typical dose of Zetia? Would one on a high dose of Lipitor be likely to also take a high dose of Zetia? What's a usual starting dose? Can anyone who is currently on Zetia, but who was formerly on Lipitor, tell me what their doses of each were/are? (Obviously, this is only for comparison's sake.) Any info would be appreciated.

 

[jeffp]

Zetia - 10mg usual daily dose. 30 pills about $88.00 retail
Lipitor - 10-80mg usual daily dosing. 30 pills about $75-196 retail (www.drugstore.com)

Sometimes Zetia is prescribed along with a statin.