More criticism of statins: - doubts are being raised over whether statins really live up to the hype about them

So much for the wonder drug - Sunday Telegraph

Extracts:

"More than three per cent of the population are now taking statins, at a cost to the NHS of £730 million last year. They have gained the reputation of being something of a wonder drug and are now prescribed not just for patients already suffering from heart disease but also for those identified as being at risk of developing cardiac problems in the future. The Government claims that its policy of encouraging the prescription of statins saves up to 7,000 lives a year.

Now, though, doubts are being raised over whether statins really live up to the hype. Dr James LeFanu, medical columnist of The Sunday Telegraph, highlighted the issue a month ago - and has since received more than 400 letters from readers who have had a less than happy experience with the drugs."

"So far, the Government and the medical establishment disagree with Dr LeFanu and those patients who have stopped taking their statins. The biggest British study into the effectiveness of the drug, published in The Lancet five years ago, followed 20,536 patients who took simvastatin or a placebo over five years. It concluded that for high-risk patients, the drug could cut the risk of heart attacks, strokes or the need for surgery to unblock arteries by about one third. Critically, it said prescribing should be widened to cover increasing numbers of patients, because it had been shown the drug was "so well tolerated and safe".

But the study, funded by the Medical Research Council and the British Heart Foundation, was unusual in one significant respect. Of 63,603 patients screened to take part in the trial, about half - 32,145 - were selected as eligible. Of these, more than one third were subsequently excluded, following a "run-in period" where they tried the drug for up to six weeks. Reasons for their exclusion varied. Overall, 26 per cent either dropped out or were deemed by researchers to be unlikely to keep taking the drugs for the full five years. A further 10 per cent were excluded because their GPs warned of increased risks due to existing health conditions. Others were excluded because of apparent side-effects, such as rising levels of liver enzymes and creatine, and, in some cases, developing muscle weakness.

So, of the 63,603 initially selected, only 20,536 continued - a mere 32 per cent. The chairman of the British Heart Foundation, Professor Peter Weissberg, admits: "It tried everyone on the drug and only the ones who didn't have side-effects were continued. That is unusual, but dozens of other trials have looked at this in a more standard way and have concluded that the side-effects are not major. One of the problems with clinical trials will always be the drop-out rate. The key thing to establish with this trial was: if you take this drug, does it save your life or not? It concluded that it does.""

It's also worth looking at relative risk and number needed to treat

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