Fears over statins use are 'misleading'


A leading researcher on cholesterol-lowering statin drugs has accused critics of misleading the public about the dangers of taking them.

Prof Sir Rory Collins said two critical articles published in the British Medical Journal (BMJ) were flawed.

But BMJ editor Dr Fiona Godlee said they were well researched.

The drugs are already offered to about seven million people in the UK who have a one-in-five chance of heart disease in the next decade.

The National Institute for Health and Care Excellence (NICE) says the scope for offering this treatment should be widened to people with as low as a one in 10 or 10% risk to save more lives.

Its recommendation follows a study which was overseen by Professor Collins' team at Oxford University.

Prof Collins criticised articles in the BMJ by John Abramson from Harvard medical school, and Aseem Malhotra, a UK cardiologist, who both claimed statins caused harmful side-effects and did not reduce mortality.

He told BBC Radio 4's Today programme: "Statins are given to people at elevated risk of heart attacks and strokes - if people at elevated risk stop taking their statins or don't start taking their statins then they will have unnecessary heart attacks and strokes, there will be unnecessary deaths from vascular causes. This is really irresponsible journalism."

He said the studies' claims, that about 20% of people suffer disabling side-effects due to statins, was not supported by the original research referenced by the papers published by the BMJ.

Research 'not released'

He told the Guardian that the reporting was creating a situation which had echoes of the MMR vaccine controversy.

"It is a serious disservice to British and international medicine," he said.

But the BMJ's editor, Dr Fiona Godlee, defended the articles, saying some research understated the risks of side-effects.

"The randomised control trial data is notoriously poor at reporting adverse events. So I think it's extremely important that the public understand when we're talking about extending statins to people at low risk, that the balance between benefits and harms becomes much more important," she said.

She added: "The articles were well written, well referenced, they were peer reviewed."

Dr Godlee also criticised the fact that the individual patient data of Prof Collins' research had not been released. "It's no longer sufficient to make widespread extension of drug treatments on the basis of data that is not widely available for scrutiny," she said.

Currently, doctors are supposed to offer statin tablets to the estimated seven million people who have a 20% chance of developing cardiovascular disease over 10 years, based on risk factors such as their age, sex, whether they smoke and what they weigh.

Doctors will need to "make a judgement" about the risks to people who have a less than 10% risk of developing cardiovascular disease and advise them appropriately, say the draft guidelines.

The NHS currently spends about £450m a year on statins. If the draft recommendations go ahead, this bill will increase substantially, although the drugs have become significantly cheaper over the years.

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