Wednesday, April 11, 2007

Is there anything that statins won't do for us?

From time to time we learn of what seems to be new health benefits from taking statins.
Here is a news item on the most recent good news for the pharma firms that make them.(of course simvastatin,and pravastatin are now generic and the once tongue in cheek suggestion to put statins in the drinking water supply may be more feasible now)
Data presented there seems to show that the risk of death from COPD decreases by a fantastic 83%.Clearly this is much better than the various inhaled medications and seems even better than long term oxygen therapy.

In December 2006 we read that statins markedly decrease the risk of advanced cancer of the prostate and their use is associated with less than 1/2 the risk of fatal or metastatic prostate cancer.

One study indicated that patients with heart failure who take statins reduce their risk of death by 24% if they use statins.

A study from Japan using a cell culture assay system reported that inteferon plus fluvastatin inhibited hepatitis C virus more effectively than did inteferon plus ribaviran.

But all the news is not good.The reported association between low levels of LDL and risk of Parkinson Disease has lead one research group to plan to launch a study to investigate the possible risk of that disease with statin use.

Fro those of us who worry about a devastating world wide epidemic of influenza and inadequate supplies of anti-viral meds, one researcher has suggested that statins may be the answer. Although there is no proof that statins are good treatment for the flu, there is one report that demonstrated by a case-control study that diabetic patients had their risk of pneumonia reduced by 50% with statin use. Still another retrospective study reported a decrease in mortality from community acquired pneumonia (OR 0.36 with a CI 0.14 - .92) in those patients who were taking statins.

There have also been studies that purport to show fewer fractures and decreased risk of dementia in statin user.This multiplicity of benefits has been attributed to the nebulous "pleotrophic" effects of the statin. Another explanation( of course calling something pleotrophic doesn't explain anything)for at least some of these associations is suggested by this publication.

The authors point out that most of these purported,non-cardiac effects were demonstrated in observational studies while the multitude of randomized control trials failed to show them. They suggest that we may be seeing the "healthy user effect". They propose that statin users tend to be folks who exhibit various "healthy" behaviors and may sometimes even belong to a different socio-economic strata.This healthy user effect was one of the proposed reasons behind the dramatic disconnect between observational studies and the randomized trials regarding hormone replacement therapy.

Before we get too giddy with the thought of all the good we are doing with the statins we need to disabuse ourselves of the notion that causal relationships regularly derive from observational studies.

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