Monday, 4 August 2014

Statins - I do love it when the right side wins

Congratulations to the British Medical Journal for coming to the only sensible conclusion in the statins war with Professor Rory Collins.

As you may recall from my previous posts i-do-like-good-fight & i-do-love-good-battle, the drugs companies, headed by the venerable Professor Collins tried to get the BMJ to retract a couple of marvelous papers (by Dr John Abramson and Dr AseemMalhotra) describing how little net benefit there is from taking statins, and that the central basis for their use (lowering cholesterol) has no effect on cardiovascular disease for most people.  

Dr Collins' pride (and possibly his pension) was wounded by the presence of a minor error that both papers made relating to the risk of side effects. The drugs companies claim that these risks are very low - they generally pre-qualified the more likely victims out of truly random trials (it would be inhumane not to!) and so their research gives a lower value than that quoted in the 2 articles. In the real world doctors don't have the luxury of ignoring the more vulnerable members of society and they report that their patients are living with higher rates of side-effects. *

In the business of criticising drug companies you are only allowed to publish data that results from clinical trials - real world experience does’t seem to count for much, and the drug companies go to great lengths to ignore it.

Anyway, the demand that a well-written article ought to be withdrawn because of a minor error is patronising in the extreme. Dr Collins' central argument appeared to be that he was more important than anyone else so we should all just do what he says. However the editor of the BMJ and the investigating panel are not to be bullied in this way; concluding that "The error did not compromise the principal arguments being made in either of the papers".

It is probably true to say that The Origin Of Species contains some minor errors of this nature, but where would we be without it? 

And indeed where would we be without authors like Dr Malhotra who are brave enough to stand toe to toe with the drugs companies and put their fists up?

* Please note that this suggestion is my own and not claimed in either of the BMJ articles. MR.

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