Thursday, October 18, 2007

More on "Is there no end to the wonders that statins will bring about?"

Here is a link to one more in the ever growing list of the wonderful things that statins can do for us all. We now learn that the rate of loss of lung function is lessened in statin users with COPD.

Earlier I had listed some of the other benefits attributed to statins . These included

decreased risk of death from COPD and heart failure
decreased risk of advanced cancer of the prostate
decreased risk of pneumonia in diabetic patients

I also previously commented a study that seemed to show a decreased risk of sepsis in dialysis patients who took a statin. I cynically wondered aloud if some or all of these observational studies on the benefits of statins were not a big push by the statin manufacturers to generate more evidence that the value of the statins extend far beyond the LDL lowering effects and include the nebulous effects "pleotrophic" effects. Such a effort could well be triggered by the market success of Zetia.

There was also the issue of the dueling case-control studies that dealt with the question "do statins decrease the risk of colon cancer" with various studies reaching opposite conclusions. That saga seemed to prove once again you should not bet the farm based on the results of a case-control study.

I certainly do not rule out that some or all of the statins may bring about some type of benefit apart from the cholesterol lowering but the fact is the studies mentioned above are observational studies and are a hotbed of all the potential biases that we learned about in doctor school and basically cannot prove causation. and we need to particularly be wary of the healthy user effect.


No comments: