A farewell to statins – part two

And so it begins:

‘ …..a Pfizer rep confirmed to me that they were now telling all GP’s that statins do have side-effects and shouldn’t be prescribed anymore but to prescribe the new post-statin drugs…………. how two-faced can you get!!!!’

This was in an e-mail from a friend and supporter of mine, who has close contacts with the pharmaceutical industry.

Well, if you are going to challenge the dominant position of statins, the first thing that you have to do is to attack them. What is the best line of attack? Go after their greatest weakness, which is that they cause serious adverse effects, and damage the quality of life of many people. Something I have been saying for a long, long, time.

For years the experts have informed us that this is utter rubbish, statins are wonder-drugs, and adverse effect free. All of a sudden, now that the pharmaceutical industry is about to launch new cholesterol lowering agents, we are suddenly going to find that, why, after all, statins do cause a whole range of nasty adverse effects.

If you want to see exactly how this is going to be done, watch this discussion on Medscape.  The Medscape site needs a password, however you can get one fairly simply. In this ‘educational’ discussion we see three professors talking about the new cholesterol lowering agents that are soon to arrive. The dreaded PCSK9-inhibitors.

The names of these three professors are Prof Christie Ballantyne, Prof Stephen Nicholls and – yes, you guessed it – Prof Steven Nissen. Is there a new cardiovascular drug in development that he does not get involved with?

The first part of the discussion focusses entirely on the terrible problem of people being statin intolerant; people being unable to take high doses of statins, and the high burden of adverse-effects from statins.

A slide is shown from the PRIMO observational study showing that 15% of people taking atorvastatin have significant adverse effects, and 20% of those taking simvastatin suffer significant adverse effects. These, of course, are the two statins with by far the greatest market share. My, what a coincidence.

The discussion then opens out into the worrying problems with statins causing both diabetes and cognitive dysfunction (something vehemently denied for many, many years). Ballantyne was particularly eloquent on these issues.

The entire tone is one more of sorrow than anger. ‘Statins….great drugs….hate to see them go, but you know, their time is passing.’ Professor wipes a small tear from his eye at the thought.

I watch this stuff with a kind of morbid fascination. The marketing game is on, billions are about to be spent pushing PCSK9-inhibitors. The Key Opinion Leaders who tirelessly promoted the wonders of statins, and who told us that they were virtually side-effect free, are now singing a completely different tune.

Here is what one the panellists Prof Christie Ballantyne had to say about statin adverse effects in his book ‘Dyslipidemia & Atherosclerosis Essentials 2009’. This can be found on page 91, under the heading Adverse Effects and Monitoring.

Statins are very well tolerated with infrequent and reversible adverse effects. In large placebo controlled studies the frequency of adverse effects was similar to placebo (2-3%).’

Here, however, is what he said in March 2013

“Some people have hereditary disorders and have extremely high LDLs. And so the statin has some efficacy but not enough to get them down as low as they’d like.  Then some people have less response than others, and we don’t understand all of that. Some of that may be genetic. And it turns out there’s an even probably larger group of people that have a hard time taking a high dose of a statin.”

Even though statins are safe for most people, there are those that can’t take them because they experience side effects.

Many people complain of some muscle pain, soreness, weakness, excessive fatigability.  There’s some slight increase in diabetes also. That can occur with high dose statins, and some people [who] say that they may have problems with their nerves or cognition.”1

Well, that is all nice and consistent. Finally, here he is on Sunday 8th Dec, quoted as part of a discussion on the new AHA/ACC guidelines.

“Clearly, the focus is to get people on statins,” said Dr. Christie Mitchell Ballantyne, the chief of cardiology and cardiovascular research at Baylor College of Medicine, in Houston. “But if someone has seen four doctors and tried six statins and tells me they can’t take them, what am I going to do? Tell them they are a failure?”

Ballantyne said he would give such patients a non-statin drug, despite the guidelines.’2

….Ballantyne said he would give such patients a non-statin drug, despite the guidelines.’ I wonder what he could possibly mean by this. Perhaps George Orwell had it right.

‘Four legs good, two legs bad’……becomes….’Four legs good, two legs better.’

“The creatures outside looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which.”

[A farewell to statins – Part three will arrive at some point.]

P.S. Please watch the video clip soon, as I suspect it may not last very long after this blog.

1: http://www.houstonpublicmedia.org/articles/1362665170-Promising-Baylor-Research-Reduces-Bad-Cholesterol.html

2: http://www.staradvertiser.com/news/20131114_New_cholesterol_advice_startles_even_some_doctors.html

56 thoughts on “A farewell to statins – part two

  1. The Healthy Epicurean

    When will the majority of GPs/Cardiologists/pharmaceutical industry (!) understand that it’s the very fact that cholesterol is lowered that causes side-effects, ergo any medication with this as its aim will cause side-effects. I’ve lost count of the number of times that I’ve tried to explain to my doctors that even ‘natural’ supplements (such as Red Yeast Rice or B3) cause vicious muscle pain in my case. Stains, fibrates, red yeast rice are all as toxic as each other in my opinion. Anyway, I don’t want my cholesterol lowered thank you very much – I function extremely well when it’s at its natural level.

    Reply
  2. Alastair McLoughlin

    Disclaimer below the Medscape video: The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

    So that’s alright then….

    Reply
    1. celia

      These three men sat there with the smug complacency of an old boys club while discussing injections which would lower our LDL to single digits! Maybe even on top of our statins…Surreal and quite shocking.

      Reply
      1. Susan

        They all had smug smirks on their faces, but Dr. Nissen in particular seemed to be having the best time discussing the problem of statin intolerance. He looked like he could barely suppress his glee over the idea that he had a new poison to push. I had to turn it off after about 5 minutes.

  3. thetinfoilhatsociety

    I’m genuinely confused. Didn’t this guy JUST sign off on the new statin guidelines…? Didn’t those JUST come out like 3 weeks ago? Didn’t the literature in the new guidelines JUST reinforce that any problems with statins are anecdotal and of no consequence…? What the heck has happened in the past 3 weeks that he’s now interviewing people who are touting new drugs instead of the ones he JUST signed off on as being the only effective ones?

    The Emperor not only isn’t clothed, he’s whoring himself out to the highest bidder it seems.

    Reply
  4. Lorna

    No apologies then for promoting, via fear and ‘medical’ propaganda, ill-health on the back of a false premise? Will there ever be follow-up research into possible correlations between statin prescription and the increase in diabetes, dementia etc? Silly question!

    Reply
  5. Anne

    Unbelievable again.

    Couldn’t help being struck by Prof Ballantyne’s badly skewed tie and shirt collar – I know that’s nothing to do with this but…

    Reply
  6. Tuan Nguyen

    Brings on the tar and feathers. These charlatans should be stripped of their professional qualifications for tarnishing medicine and bringing it into disrepute. They should out of town instead of being allowed on tv.

    Reply
  7. dearieme

    All such interviews and discussions should start with the participants telling us their own cholesterol numbers and their own medication. Then when someone says how fascinating it would be to drive down LDL to a gazzilionth of whatever, we could chuck rotten eggs at him.

    Reply
    1. yasmine ballantyne

      I have been married to christie Ballantyne for almost 34 years. he exercises regularly, follows a healthy diet, and has taken a statin for well over 12 years. every morning, he takes his statin!!!!! his father had open heart surgery in his early 50″s, and with perfect weight, diet and exercise, doctor Ballantyne still has to take a statin, because” his lipid profile ” is still not optimal. Ballantyne trained in cardiology and also genetics.
      I see a lot of talk on this blog, but not much scientific knowledge.
      the fact is that no one needs to take any medication if they feel that it is not in their best interest to do so. I do not know of any instance when a patient was forced to take a statin or any other meds. If you know of one, let me know.

      Reply
      1. Dr. Malcolm Kendrick Post author

        Yasmine, thank you for your comment. I would question the assertion that there is not much scientific knowledge on this blog. There are many doctors contributing, scientists, a professor or two, with a great deal of scientific referencing. However, one must suppose that a blog is primarily about discussions, it is not a scientific journal. Whilst it is true that no-one can be forced to take a statin, the reality is that a number of people have told me that a: their doctors have told them they must, or they will be thrown off their lists b: various insurance companies demand that they do, or else their insurance payments will go up c: the doctors have basically bullied and cajoled them etc. So, no, no-one has a statin forced down their throats, but the threats and intimidation are difficult to resist. Whilst I fully understand that you wish to defend your husbands position in this area, perhaps you could ask him why his position on statins adverse effects has altered so dramatically. To the outsider this simply looks like a massive conflict of interest, as he is now working with companies who make the PCSK9-inhibitors, and it is commercially critical for these companies to highlight statin adverse effects.

        I hate to point it out, but your comment contains no scientific ‘knowledge’ at all. It is purely anecdote. Whether or not Christie Ballantyne takes a statin!!!!! every morning is irrelevant to any any discussion on the benefits of statins, as he would surely agree.

      2. David Bailey

        Yasmine,

        I think it is encouraging that you are contributing to this blog, but it would be even better if your husband were to engage in a little debate here.

        I took statins for 3 years without ill effect, and thought of them as a great way to protect myself from heart disease/stroke. Then I started to get intense cramps and additional weakness in my right leg, which is weakened due to polio as a child. My doctor didn’t connect this problem to statins, but it is fortunate that I remembered that one of the side effects of statins is ‘sore’ muscles.All in all, I tried stopping and starting the statins 3 times – each time the problems started to diminish, and resumed when I began taking Simvastatin again! At one point things were so bad, I feared I might not remain mobile, and that I might have Post Polio Syndrome. During a period when I was not taking the statin, I went to see a specialist, who decided I did not have PPS mainly because I seemed to be recovering at the time!

        Eventually the penny dropped – my symptoms were entirely due to Simvastatin, and it took about 9 months for me to return completely to normal. I was amazed to discover that this supposedly safe drug had done this to my body! Of course, I described my experience to many people (who had not had polio), and was surprised to discover just how many had had troubles of their own from this drug. After all, I have read articles in the press suggesting that most statin side effects are nocebo effects, and that real side effects are rare (1 in 10000 was one figure)! One of the people I talked to had suffered from both muscle problems and another side effect – memory problems. Both these problems cleared up after he gave up on statins, but I am sure I don’t need to tell you just how frightening it must be to experience memory problems at our time of life. It was also frightening to fear that my essentially normal lifestyle after polio might be about to end.

        Part of the reason that I participate here, is that I am appalled by the thought that there may be people suffering my symptoms and perhaps the memory problems I described above, who continue to follow medical advice and take statins while they are in considerable pain and struggling to stay mobile. Those with memory problems might even end up in a care home, being fed statins by their carers every day!

        I have a PhD in chemistry – but nothing related to biochemistry, and I must say, your comment about the lack of scientific knowledge in this blog, suggests you have not read much here.

        I would strongly urge that you obtain Dr Kendick’s book, and try to sit down with your husband and try to elicit a detailed explanation of where the logic of his argument is flawed – particularly as they relate to the various epidemiological studies that have been made into the correlation between saturated fat intake/cholesterol and cardiovascular problems, and the studies into changes in mortality that various groups of patients that receive these drugs enjoy.

        While you are at it, you might ask him whether my experience can possibly be consistent with statin side-effects being rare.

  8. Janknitz

    Isn’t this just like the perfect crime? Now that the patents are running out, they can leave the generic statin makers holding the bag of responsibility for the side effects that they denied were happening when the patents active (“Neener, neener generic drug makers, you can’t ride our coattails!”). Meanwhile, they can push a new type of drug and enjoy a long patent period before they have to start admitting new problems. Clever crooks these guys.

    Reply
  9. Stephen Rhodes

    Do you know whether the new PCSK9 inhibitors are available as suppositories?

    It will make it much easier for my GP when I tell him where stick them.

    Reply
  10. dearieme

    Height is a risk factor for prostate cancer. It doesn’t mean that you can reduce the risk of the cancer by being cut off at the knees.

    Reply
  11. John Mason

    After a heart attack, and subsequently being put on high doses of Lipitor and the other heart healthy drugs, I suffered 10 months of life threatening depression and anxiety. Through my own research, discovered the term cardiac depression..brought on by the life threatening event and lack of hospitalization to fully come to terms with my condition.
    I really was in a terrible state. Came off the statins after about 6 months…4 months later my mental turmoil lifted.

    Was it the event? The medication? I don’t know. But I know where my suspicions lie.

    Reply
  12. mjohnson9706

    In watching this video, I noticed at the top it was released on June 6, 2013 and am wondering if this video was hidden until after the new statins guidelines were pushed through? Thank you for all you do.

    Reply
  13. Pingback: A farewell to statins – part two | Bydio

  14. Craig Fischer

    Well its getting pretty desperate isn’t it? It must surely all implode sometime soon, although likely in a non-litigious manner. RUN!

    The days of the barber-surgeon are not far behind us. Add in the drug barons and there you have it. I think we should follow some very old medical advice from Bald’s Leechbook :
    “In case a man be a lunatic; take skin of a mereswine or porpoise, work it into a whip, swinge the man therewith, soon he will be well. Amen.’ (III, xl)”

    a regular horsewhip might be a useful alternative
    Craig.

    Reply
  15. Peter Robins

    Malcolm, Malcolm, Malcolm

    These guys aren’t talking about side effects. They didn’t mention “side effects” once.

    They are talking “intolerance” a totally different thing!

    The fact that 30-40% of people become intolerant over the period of one year is neither here no there,

    I wonder how much these guys earn a year and also how they manage to internalise this crap so, as I think they must somehow believe what they say?

    Pete

    Reply
    1. Dr. Malcolm Kendrick Post author

      Pete, the correct term is adverse effects, I believe. A side effect can be bad, or good. Yes, there is another game that they are playing. They say intolerance, because that means you need another drug to overcome the intolerance. Just as people who have intolerance to very cheap aspirin need very expensive clopidogrel. So, people who have intolerance to very cheap statins will need eye wateringly expensive PCSK9-inhibitors. In truth, though, they are talking about side-effects/adverse-effects. If someone cannot tolerate a drug, it is because of adverse effects – end of. The reality is that the marketing people have told them to use the term intolerance, as it fits the marketing strategy where intolerance can both mean adverse effects, and the fact that you can’t get the LDL level down low enough. They are changing the language. The next game to be played is to overcome the latest AHA/ACC guidelines which stated that LDL targets were irrelevant. You get a special prize for working out how they do this.

      Reply
      1. amieres

        Also the beauty of calling it intolerance is that it sounds like the fault is yours if YOU are intolerant to the drug. Such a perfectly nice drug but you are the intolerant one, tsk, tsk, tsk.

      2. David Bailey

        Perhaps it is also worth pointing out that in my experience people don’t get offered a genetic check to determine if they are likely to be ‘intolerant’ before they are put on statins, or even when they encounter problems!

  16. Alastair McLoughlin

    Side effects – adverse effects….you say tomato….I say…
    What we’re really talking about is the human body’s reaction to toxic chemicals being thrust into them at every opportunity.

    Reply
    1. Dr. Malcolm Kendrick Post author

      On one level I agree. however, I tend to use the term adverse effects as it is more accurate. A side-effect of aspirin was to reduce the risk of heart attacks. But this is a good thing, not a bad thing.

      Reply
  17. Max Power

    It’s game on for Big Pharma again, a new wonderdrug has been discovered & the experts have been bought & sold, time to get this stuff marketed & rake in the profits 2014…

    Reply
  18. blackdog

    This is a typical Pharma tactic; once the patent expires, retreat from the battlefield and leave it to the generic makers because we now have a ‘better mousetrap’. Of course it will not have been ‘tested’ in the way you and I know, but will jump the low bar of the FDA, by adding up all of the numbers in the RCT’s until they can show it’s slightly better than placebo. Or better still hiding the data on the trials that didn’t work.

    Then, the next step is to get a few ‘noted speakers’ to promote the concept on the back of the soon to be announced drug, which will have a name, thought up by some marketing geek that bears no relationship whatsoever, to the mechanism of the drug (bococizumab?) such as SSRI which allegedly blocked the reuptake of serotonine exclusively, when in fact it was much the same as amphetamines or amtriptylene or most drugs derived from the early sedating antihistamines. One thing that is certain; any replacement for statins will be much more expensive than any previous drug both to buy and administer (as is always the case). These guys are promoting a drug that alters genetic structures and may bring about permanent modification of cellular function in humans; we just don’t know. I think we do this sort of thing at our peril, like taking Clopidogrel does.

    These new PCSK9 drugs have to be injected and are accompanied by steroids (by mouth), antihistamines and usually good old acetaminophen (paracetomol) all to reduce injection site problems so a new bonanza opens up for Pharma and the those who administer the protocol. ‘Biologics’ (as these are called) are the new pathway for drugs developement at the moment, which opens up a whole new can of worms for patients to beware of, or should I say scared?

    Reply
    1. celia

      blackdog, your final paragraph left me feeling quite cold. I was wondering how many patients would agree to all this, then thought of people in hospital after an operation. How vulnerable they are to whatever the medical profession do to them. It doesn’t bear thinking about…

      Reply
    2. Susan

      That last paragraph got to me too…
      They now want us to agree to inject a drug that then requires us to take THREE MORE drugs just so we can tolerate the adverse effects?
      Curiouser and curiouser! cried Alice…

      Reply
  19. Stephen Rhodes

    From Dr. Mercola’s website at http://articles.mercola.com/sites/articles/archive/2013/07/29/pcsk9-cholesterol-drug.aspx he says;
    “Researchers discovered that people with underactive PCSK9 genes had low levels of LDL. They also had low levels of cardiovascular disease.”

    Loads of web hits on exactly this form of words but I can find no reference to the research that shows that those with an underactive PCSK9 gene have lower levels of cardiovascular disease/

    Does anyone have any links to this research, since without such a benefit, this drug will be no better and perhaps worse than statins?

    Reply
      1. Stephen Rhodes

        I have tracked down the 2006 research (haha) paper on which the claim of efficacy of the PCSK9 inhibitors appears to be based – viz. the reduction in CVD in those with the reduced expression of the gene.

        It is published in the New England Journal of Medicine at http://www.nejm.org/doi/full/10.1056/NEJMoa054013 and some of the language suggests the authors might have been happier living in pre-Mandela South Africa. Who still expects to be taken seriously when they are supposed to be analysing the racial origins of genotypes if they refer to “blacks and whites”.

        I doubt you will find the paper compelling.

        The authors take some pains to explain away the CVD deaths among those blessed with the genetic defect that is the subject of the paper, pointing out whenever one of them has shuffled off as a result of the defect that ‘of course’ they smoked/were obese/were highly hypertensive etc etc.
        By the same token there is no similar critical analysis of why those not lucky enough to have a defective genome died of CVD, no analysis of their diet/exercise regime/diabesity etc etc.

        Bad science!

    1. Steve Morrissey

      #Stephen Rhodes #Dr Malcolm Kendrick
      There have been a number of studies looking at variants of PCSK9. Some have found that some variants are linked to low LDL levels; some have found that variants of PCSK9 are linked to lower LDL and lower heart disease [1]. A study based on data from the Prosper statin trial identified people with one particular PCKS9 variant as having lower LDL levels, but these lower LDL levels weren’t found to be linked to lower rates of heart disease. This study did not give any results for overall mortality [2].
      A great deal of the excitement is that fact that PCSK9 inhibitors do lower plasma LDL and that is assumed to be a good thing.
      The view I take is that variants of PCSK9 that do not degrade LDL receptors in the arteries could be linked to less cardiovascular disease since the additional LDL receptors would allow the arteries to receive more nutrients eg cholesterol and the fat soluble vitamins like vitamin K2. However there is a trade off, it can mean that that other parts of the body receive less nutrients. It also means that the blood plasma carries less LDL particles, this is a significant trade off because higher plasma LDL levels are linked to increased resistance to infection since LDL neutralises bacterial toxins. Lack of functional PCSK9 will also open up many cells to infection by viruses which use LDL receptors as a means of entry [3, 4]. I believe that PCSK9 has even been patented as an antiviral agent.
      Reading aboutPCSK9 I came across a number of papers related to brain health. It is possible that PCSK9 might be important for the brain [5]. One study indicated that lack of PCSK9 in the mouse brain lead to increased levels of amyloid beta peptide [6]. A later study said that it didn’t have this affect in the mouse brain [7]. Another study suggested that PCSK9 did have an effect on the developing mouse brain [8], though the authors concluded that the effect would not be important for the human brain. One argument used was that people who are naturally deficient in working PCSK9 appear healthy and have a normal lifespan, though I wouldn’t be totally convinced by this argument since the majority of the people who are naturally deficient in working PCSK9 usually are heterozygous ie they have fully functional PCSK9 from one parent.
      A study looking at a different PSCK namely PCSK7 found that it was linked to the health of developing embryos [9], though this was in zebra fish. The authors expressed the view that this effect needed to be borne in mind with the newly developed PCSK9 inhibitors. The danger is that the PCSK9 inhibitor might also inhibit PCSK7 to some extent. I would imagine that a PCSK9 inhibitor might not be recommended for an expectant mother. Another PCSK, PCSK4 has been linked to sperm health. So there could be a question on male fertility and PCSK9 inhibitors. People borne naturally with less functional PCSK9 should not have the above problems since they should have normal PCSK7 and PCSK4. If it can be shown that the PCSK9 inhibitors do not inhibit any of the other types of PCSKs then there shouldn’t be a problem.
      One paper on the use of PCSK9 did say that the inhibitors could lead to increased viral infection and that this needed to be monitored. This paper also warned that the body could develop antibodies to the inhibitors and that this could result in arthritis [10].
      So these trials are taking people into unknown territory. The worst result could be if there is some marginal benefit in the short term and there are long term drawbacks that don’t get spotted.

      References
      (1) Benn M, Nordestgaard BG, Grande P, Schnohr P, Tybjærg-Hansen A. PCSK9 R46L, Low-Density Lipoprotein Cholesterol Levels, and Risk of Ischemic Heart Disease3 Independent Studies and Meta-Analyses. J Am Coll Cardiol 2010;55(25):2833-2842.
      http://www.ncbi.nlm.nih.gov/pubmed/20579540

      (2) Polisecki E, Peter I, Robertson M, McMahon AD, Ford I, Packard C, et al. Genetic variation at the PCSK9 locus moderately lowers low-density lipoprotein cholesterol levels, but does not significantly lower vascular disease risk in an elderly population. Atherosclerosis 2008;200(1):95-101.
      http://www.ncbi.nlm.nih.gov/pubmed/18262190

      (3) Agnello V, Ábel G, Elfahal M, Knight GB, Zhang QX. Hepatitis C virus and other flaviviridae viruses enter cells via low density lipoprotein receptor. Proceedings of the National Academy of Sciences 1999;96(22):12766-12771.
      http://www.ncbi.nlm.nih.gov/pubmed/10535997

      (4) Labonte P, Begley S, Guevin C, Asselin M, Nassoury N, Mayer G, et al. PCSK9 Impedes Hepatitis C Virus Infection In Vitro and Modulates Liver CD81 Expression. Hepatology 2009 JUL;50(1):17-24.
      http://www.ncbi.nlm.nih.gov/pubmed/19489072

      (5) Poirier S, Prat A, Marcinkiewicz E, Paquin J, Chitramuthu BP, Baranowski D, et al. Implication of the proprotein convertase NARC‐1/PCSK9 in the development of the nervous system. J Neurochem 2006;98(3):838-850.
      http://www.ncbi.nlm.nih.gov/pubmed/16893422

      (6) Jonas MC, Costantini C, Puglielli L. PCSK9 is required for the disposal of non-acetylated intermediates of the nascent membrane protein BACE1. EMBO Rep 2008;9(9):916-922.
      http://www.ncbi.nlm.nih.gov/pubmed/18660751
      (7) Liu M, Wu G, Baysarowich J, Kavana M, Addona GH, Bierilo KK, et al. PCSK9 is not involved in the degradation of LDL receptors and BACE1 in the adult mouse brain. J Lipid Res 2010;51(9):2611-2618.
      http://www.ncbi.nlm.nih.gov/pubmed/20453200

      (8) Rousselet E, Marcinkiewicz J, Kriz J, Zhou A, Hatten ME, Prat A, et al. PCSK9 reduces the protein levels of the LDL receptor in mouse brain during development and after ischemic stroke. J Lipid Res 2011;52(7):1383-1391.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3111744/

      (9) Turpeinen H, Oksanen A, Kivinen V, Kukkurainen S, Uusimaki A, Ramet M, et al. Proprotein Convertase Subtilisin/Kexin Type 7 (PCSK7) Is Essential for the Zebrafish Development and Bioavailability of Transforming Growth Factor Beta 1a (TGFβ1a). J Biol Chem 2013:jbc. M113. 453183.
      http://www.ncbi.nlm.nih.gov/pubmed/24178295

      (10) Poirier S, Mayer G. The biology of PCSK9 from the endoplasmic reticulum to lysosomes: new and emerging therapeutics to control low-density lipoprotein cholesterol. Drug design, development and therapy 2013;7:1135.
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793591/#!po=91.6667

      Reply
  20. Barry

    The scare campaign continues:

    http://www.news.com.au/lifestyle/health/abc-tv-show-catalyst-could-cause-3000-heart-attacks/story-fneuzlbd-1226780002493

    “The ABC’s Independent Audience and Consumer Affairs Unit is conducting the investigation into the Catalyst program and its findings are due to be released before Christmas.
    The inquiry will decide whether the program was in accordance with the ABC’s editorial policies and any penalties would be “in the hands of management'”, a spokesman said.”

    Reply
    1. celia

      What, penalties for telling the truth? What is the world coming to when you can’t inform the public of things they should know, yet the drug companies and their buddies can state things which are actually not true? What about some prospective penalties for them?

      Reply
  21. Robert

    The other day I walked into the library. I asked to see a copy of the JUPITER study on Crestor. The librarian said the fictional section is to your left.

    Reply
  22. Dr Paul Travis

    The Medscape web page has a small box top right saying, “The Cleveland Clinic Foundation Center for Continuing Education acknowledges an educational grant for support of this activity from Amgen”. Steve Nissen is professor of medicine at the Cleveland Clinic. Amgen’s own PCSK9 Inhibitor is currently in trials. Is there a connection? To be fair Prof Nissen disclosed no relevant financial relationships. Good to know that the educational grant probably went towards library books and not a fine dining experience for Nissen et al at the expense of Big Pharma.

    …and I achieved 30 minutes CME credits for watching this rubbish so not a complete waste of time!

    Reply
    1. Dr. Malcolm Kendrick Post author

      Steven Nissen has no conflicts of interest. Pharmaceutical companies pay the Cleveland Clinic, the Cleveland Clinic pays him. All money he receives for consultancy work goes to charity. So he informs the world. What is a conflict of interest….well, no-one has really defined this in any way. If a pharmaceutical company pays money to a charity, and the charity then pays you, are you conflicted? Heart UK is a charity.

      Reply
    1. celia

      I heard last night on the PBS News Hour in the USA that Klaxo SmithKline have announced they are going to stop their financial connections with doctors and also stop rewarding their drug reps each time a doctor signs a prescription. What is going on???

      Reply
      1. Dr. Malcolm Kendrick Post author

        Klaxo? I think I prefer it.

        What is going on, is that GSK got caught. Now they are pretending to occupy the moral high ground. They will keep on paying doctors, but they will just do it in a more roundabout way. Watch out for a whole new raft of medical ‘charities’ being set up. Charities that doctors will do work for, and pharmaceutical companies will support. [They already do quite a lot of this, but it will become far more common].

        You heard it here first.

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