The Editor, Sir:
I appreciate your attention to the important issue of drug adverse effects for statins in the article 'Rattray wrong on cholesterol drugs' by Dr. Anthony Vendryes, published in the March 23, 2007 issue of the Jamaica Gleaner Online.
However, I was distressed to see that I was mischaracterised as saying that 98 per cent of patients on Lipitor get muscle problems, and that a third of patients on Mevacor do so. This statement is patently untrue, and I never did nor ever would say it. In one analysis focused on 100 subjects who experienced muscle problems that they attributed to statins, 98 per cent met literature criteria for probable drug causality. (A later analysis showed a somewhat lower fraction, though still very high).
That is the only 98 per cent I can imagine having alluded to. The sample was already selected for having muscle problems on statins - it can make no characterisation about the fraction of people on statins who report such problems. Additionally, it is true that rates of adverse effects up to a third have been reported in some observational studies of statins (particularly at higher dose), though other studies report lower rates.
Adverse effects of statins absolutely need to be considered together with their benefits in making treatment decisions. However, such serious mischaracterisation of statements by those of us interested in adding balance to the discussion of statins damages the credibility of those of us who are interested in ensuring consideration of the full risk benefit balance; which can only hurt the cause of adding balance to the discussion.
I am, etc.,
| BEATRICE GOLOMB, MD, | | PhD, Associate Professor of | | Medicine, University of | | | California, San Diego | | | bgolomb@ucsd.edu |
UCSD Department of Medicine 9500 Gilman Drive #0995 La Jolla, CA Via Go-Jamaica
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