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Posted 09 November 2008 - 03:24 PM
Healthy men and women with good cholesterol levels could significantly reduce their risk of heart disease by taking cholesterol-lowering drugs, better known as statins, according to a study released Sunday.
Today, only people with high levels of cholesterol are prescribed cholesterol-lowering drugs, known as statins.
Today, only people with high levels of cholesterol are prescribed cholesterol-lowering drugs, known as statins.
Nearly 18,000 people in 26 countries, including 7,000 women and nearly 5,000 minorities, participated in the clinical trial, the results of which were published in The New England Journal of Medicine.
All had very good cholesterol levels, with average LDL -- or "bad" cholesterol -- levels of 108 and average HDL --or "good" cholesterol -- levels of 49.
However, each participant had elevated levels of "high-sensitivity C-reactive protein" or hs-CRP -- a marker that indicates inflammation in the body and can contribute to coronary heart disease, the No. 1 killer of men and women in the United States.
Under the current guidelines set for lowering cholesterol levels, none of the participants would have qualified for taking statins.
In the study, the participants took 20 milligrams of the drug Rosuvastatin -- commercially known as Crestor -- or a placebo pill.
The maker of Crestor, AstraZeneca, funded the study.
According to the lead author, Dr. Paul Ridker of the Brigham and Women's Hospital in Boston, Massachusetts, the pharmaceutical company had no input in the study's design and didn't see the final data analysis until the study was submitted for publication.
Designed to last up to five years, the trial was stopped after less than two because endpoints set by an independent oversight committee were met, the study says.
Researchers found that participants taking Crestor cut their risk of heart attack, stroke and death by nearly half -- 44 percent -- compared with participants taking the placebo.
Posted 09 November 2008 - 05:33 PM
A large study with a significant positive result. I know many people here are on the anti-pharma bandwagon, just wondering what you all think of the study.
I still don't see the need to take statins when inflammation and cholesterol levels can be controlled so easily and effectively through diet and natural supplements.
Researchers found that participants taking Crestor cut their risk of heart attack, stroke and death by nearly half -- 44 percent -- compared with participants taking the placebo.
Edited by david ellis, 09 November 2008 - 05:34 PM.
Posted 11 November 2008 - 03:12 AM
Posted 11 November 2008 - 03:26 AM
3.3 heart attacks or strokes (especially strokes!) avoided for the cost of 100 people taking statins doesn't sound like that bad of a value. How many person-years of life are we saving per dollar? What would be the cost to care for a stroke victim until they die? Aren't there statins that are off patent, or nearly so? That will change the cost equation dramatically. If this application is only to persons with high hs-CRP, it's not like we'd be treating everyone; where did the $10B figure come from? Seems kind of high if it's only applied to hs-CRP patients.44% sounds like a significant result, but it isn't. The previously advertised 33% reduction was not impressive. It was 3.3 people saved out of 100 people taking statins. Millions spent on stains versus four less heart attacks and strokes. On the face of it, statins don't seem cost effective.
Posted 11 November 2008 - 04:17 AM
3.3 heart attacks or strokes (especially strokes!) avoided for the cost of 100 people taking statins doesn't sound like that bad of a value. How many person-years of life are we saving per dollar? What would be the cost to care for a stroke victim until they die? Aren't there statins that are off patent, or nearly so? That will change the cost equation dramatically. If this application is only to persons with high hs-CRP, it's not like we'd be treating everyone; where did the $10B figure come from? Seems kind of high if it's only applied to hs-CRP patients.44% sounds like a significant result, but it isn't. The previously advertised 33% reduction was not impressive. It was 3.3 people saved out of 100 people taking statins. Millions spent on stains versus four less heart attacks and strokes. On the face of it, statins don't seem cost effective.
Posted 11 November 2008 - 02:16 PM
Edited by aikikai, 11 November 2008 - 02:16 PM.
Posted 11 November 2008 - 07:05 PM
Or just imagine they'd give the money to the Mfoundation. Much better.Using Crestor to prevent heart attacks and save lives in apparently healthy people would add nearly $10 billion a year to the nation's medical bill, according to calculations released Monday.
Resveratrol, or other sirtuin activators, will do this for much less.
Posted 11 November 2008 - 07:36 PM
They did focus on inflammation, not cholesterol. The study specifically looked at treating people with normal or low cholesterol, but with high CRP. The statin cut CRP by more than half, with an accompanying huge reduction in heart attacks.You are right Mind, why don't they focus on inflammation rather than total cholesterol? There are better predictors of CVD. Calcium scores, CRP, Lp(a), oxidized LDL, even an inexpensive Triglycerides/HDL ratio, are much better predictors that total cholesterol.
Posted 11 November 2008 - 08:10 PM
3.3 heart attacks or strokes (especially strokes!) avoided for the cost of 100 people taking statins doesn't sound like that bad of a value. How many person-years of life are we saving per dollar? What would be the cost to care for a stroke victim until they die? Aren't there statins that are off patent, or nearly so? That will change the cost equation dramatically. If this application is only to persons with high hs-CRP, it's not like we'd be treating everyone; where did the $10B figure come from? Seems kind of high if it's only applied to hs-CRP patients.44% sounds like a significant result, but it isn't. The previously advertised 33% reduction was not impressive. It was 3.3 people saved out of 100 people taking statins. Millions spent on stains versus four less heart attacks and strokes. On the face of it, statins don't seem cost effective.
Posted 11 November 2008 - 11:56 PM
The statin cut CRP by more than half, with an accompanying huge reduction in heart attacks.
david-If I had elevated CRP that couldn't be controlled by lifestyle or supplements, I would seriously consider taking a statin.
Posted 12 November 2008 - 01:13 AM
My experience using fish oil and curcumin. All safe, low cost supplements. Lowered my hsCRP to 15% of its initial value.
Lab-Corp reference range 0-3 mg/L
06/02/05 C-Reactive Protein, Cardiac 3.3 mg/L
08/23/06 C-Reactive Protein, Cardiac 1.3 mg/L
04/19/07 C-Reactive Protein, Cardiac 5.3 mg/L
05/14/07 C-Reactive Protein, Cardiac 0.9 mg/L
05/18/07 C-Reactive Protein, Cardiac 1.7 mg/L
05/07/08 C-Reactive Protein, Cardiac 0.5 mg/L
Edited by bgwowk, 12 November 2008 - 01:17 AM.
Posted 12 November 2008 - 05:00 AM
I don't like big pharma either, but they are not intrinsically bad guys. If people want a system where government dictates what medicines can be advertised as efficacious based on large expensive clinical trials, then medicines produced by the system will necessarily be expensive and unnatural so that they can make enough money to pay for the trials. The high cost of health care is not so much a product of greed as it is of a society with no political tolerance for risk in medicine.
Posted 12 November 2008 - 06:56 AM
Posted 12 November 2008 - 05:35 PM
Thalidomide baby problems are much less likely now, and I am happy with the progress made by both business and government working together in the last 46 years. I am not arguing that government doesn't need reform, it obviously does, I am just pointing out another obvious fact that what is good for pharma, is not necessarily good for the country. I am for business, my retirement portfolio depends on business being successful.It was government that created the system in which getting permission to sell one new drug takes ten years and almost one billion dollars, and in which it is illegal for even dying patients to try medicines not approved by the FDA. The whole FDA/big-pharma infrastructure is a direct result of laws made by politicians believing they are protecting common interest.
The difference between greedy business vs. government protecting the common interest is the difference between gains in computer performance vs. gains in disease treatment over the past 46 years since the Kefauver Harris Amendment. I prefer the rate of gain achieved by greedy business, thanks.
Posted 12 November 2008 - 07:00 PM
Edited by edward, 13 November 2008 - 03:26 AM.
Posted 13 November 2008 - 12:19 AM
The high cost of health care is not so much a product of greed as it is of a society with no political tolerance for risk in medicine.
Posted 13 November 2008 - 02:16 AM
This is a good illustration of why free market principles don't work for medicine. Pharma is doing what it can to maximize its profits. They are ensuring that their customer base and profits are huge. There is an asymmetry of information. Pharma talks about relative risk, patients don't know the difference between relative risk and absolute risk. Pharma knows about side effects, but do not have to fully divulge what they know. Pharma can keep doing studies until they get a good result. There is no obligation to divulge studies that failed. With asymetrical information, patients will always get the short end of the stick.
Posted 13 November 2008 - 05:40 AM
If creating medicines that are both effective and safe were even remotely as easy a problem as building a faster computer, this comparison might be meaningful. The problem, as you noted, is that our society has little political tolerance for risk. This is a bit more understandable when you consider what that risk looks like up close; a stream of injured and dead people, including such situations as the thalidomide tragedy.It was government that created the system in which getting permission to sell one new drug takes ten years and almost one billion dollars, and in which it is illegal for even dying patients to try medicines not approved by the FDA. The whole FDA/big-pharma infrastructure is a direct result of laws made by politicians believing they are protecting common interest.
The difference between greedy business vs. government protecting the common interest is the difference between gains in computer performance vs. gains in disease treatment over the past 46 years since the Kefauver Harris Amendment. I prefer the rate of gain achieved by greedy business, thanks.
Posted 13 November 2008 - 06:06 AM
Posted 13 November 2008 - 01:07 PM
Posted 14 November 2008 - 08:57 PM
Posted 14 November 2008 - 09:34 PM
I would just like to factor something else in here that hasn't been mentioned so far regardless of whether or not taking Crestor/rosuvastatin is a good idea for people like us or whether you view the pharma industry or the studies it funds with suspicion or not.
Currently, legislation does not support drugs that promote longevity, only ones that cure diseases and aging is not classified as a disease. Look at what Sirtris/GSK have had to do with resveratrol derivatives - test them against diabetes but in the expectation that any drug being approved would get used off label for longevity.
This legislative barrier will need to be removed before we get any significant progress in longevity medicine.
Astrazeneca have just funded a study that brings this issue into focus - concrete evidence that a drug may prevent cardiovascular disease and keep healthy people healthier longer. I would say that if anyone has a chance of getting the necessary changes in legislation, it is likely to be the drug companies.
Personally, I see this study as a significant step towards compiling a body of evidence to lobby for a change in legislation and therefore a significant step towards longevity medicine becoming a reality and I think we should welcome and support it.
Best Regards,
Alistair
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