Dr. Paul Mason - 'The truth about statins'

[Music] g'day i'm dr paul mason today i'm going to tell you about the history of statins and then have a look at how the science has been distorted tens of millions of people around the world take statins and they've been incredibly profitable in fact lipitor the one on the bottom left has more than 150 billion us dollars of sales so the first question is how did statins get so popular and that story begins in 1913 with this man the russian scientist nikolay anikov he force-fed rabbits pure cholesterol and found that he could induce atherosclerosis over time his studies led to the development of the lipid heart hypothesis the theory that dietary saturated fat and cholesterol is the major cause of heart disease never mind that rabbits are herbivores or that the atherosclerosis in the rabbits was different to what we see in humans and by the mid-1950s pharmaceutical companies the world over were beavering away in their laboratories trying to find a drug that could lower the level of cholesterol one of these the william s merrill company the same company that introduced thalidomide to the united states found a new drug which could lower cholesterol levels known as triparanol or myrrh 29 merrell was granted fda approval in 1959 after which it rapidly became a commercial success profits at side however it was an unmitigated disaster in 1962 it was withdrawn from the market after significant and permanent side effects were suffered by many here for example you can see a permanent cataract in the eye of a six-year-old boy among other side effects were hair loss severe dermatitis and ironically accelerated atherosclerosis the very condition it was meant to prevent all from a drug which impaired the body's natural production of cholesterol it was almost as if it wasn't a good idea and these side effects shouldn't have been a surprise preclinical testing in animals had revealed multiple issues with this drug this rat for instance was the only survivor out of 44 after nine weeks of dosing with triperinol and in 1963 a federal grand jury found that the william s merrill company had both withhold data pertaining to the dangers of their drug while also falsifying data for example graff were redrawn cataracts never reported knowledge of symptoms such as hair loss were denied when asked company salesmen were instructed on how to blame other drugs meryl ended up being fined 80 000 followed by about 50 million dollars in costs to settle subsequent civil lawsuits and this led to a vacuum a belief that serum cholesterol was dangerous and no drugs to treat it with and it was in this vacuum that statins were born in 1976 japanese scientist akira endo extracted a mycotoxin known as ml236b which became the first experimental statin and by 1979 senkayo a japanese pharmaceutical company and merck were both working on the same statin in a race to bring it to the market they knew whoever would win the race it would be lucrative and then suddenly in 1980 sankayo pulled out of the race it seemed that about half of their test dogs dosed with the statin were developing intestinal lymphoma a cancer of the small intestine they simply deemed the drug too dangerous and later that year after hearing of sankaya's discovery merck followed suit also pulling the pin over the following years however scientists at merck lobbied to continue their research they threw some shade at their japanese counterparts suggesting that they were mistaken about their test animals having cancer as if that was something that they could be mistaken about and they carried on ultimately merck received fda approval for the first saturn in 1987 the very same statin sankaya had decided was too dangerous its name lovastatin of course the story doesn't stop there in 1990 the national institute of health convened a panel to discuss the possibility that decreasing cholesterol levels may be intrinsically dangerous and the panel ultimately concluded that this could be true and then in 2001 bayer a multinational pharmaceutical company recalled their statin bachol after a series of fatalities despite occurring this century most people have no idea that bayer has paid out well in excess of a billion dollars to settle thousands of lawsuits arising from harms caused by this statin and the list of potential harms caused by statins is long they can cause symptoms of dementia increase the risk of osteoporosis lower testosterone levels are associated with erectile dysfunction and shrunken testicles and they even increase a chance of becoming diabetic for instance the woman's health initiative found that those taking statins had a 71 increased risk of diabetes and don't think that these side effects are a secret all you need to do is to take out the drug insert in the box and there you'll see warnings of liver cancer severe muscle damage in actual fact a warning that caution should be used to prescribing statins over the age of 65 blood in the urine and increased risk of diabetes amongst other things the list of issues reported in post-marketing surveillance is even more impressive ranging from depression and insomnia to lung disease and gynecomastia of course one might be reassured by claims that the rate of adverse events from statins is very low less than one in a hundred one in two hundred even especially when these claims are made by the likes of sir rory collins an esteemed professor of medicine at oxford university it doesn't make much sense though that the same rory collins would file for a patent for a test seeking to identify those patients most at risk of statin side effects or that a website selling his patented test would claim up to 29 of statin users suffer muscle problems the fact is 29 is probably closer to the truth than half to 1 you see statin studies are often designed in a way that leads to underestimation of the true rate of side effects take for example this large study which used something called a running period before the trial started potential subjects were dosed with first a placebo and then a statin for four to six weeks and anyone suffering side effects was excluded from the study more than one third of potential subjects over 11 000 of them were removed and when you remove people with side effects before a study starts is it any wonder the side effect rate is low the truth is more than one in five patients cannot tolerate standard dose statin therapy and this is drug company data i derived it from a study on a newer more expensive cholesterol lowering agent and buried in the data in this paper was the intolerance rate to statins as assessed by at least two doctors and understand that most people would be willing to tolerate mild statin side effects if they thought it would help them live longer which suggests that symptoms preventing one in five patients from taking standard dose sentence are more than mild which leads to the question if statins can have these side effects how beneficial are they in prolonging life or more precisely by how long will the average person taking a statin increase their lifespan by and this excellent paper answers that question by creating the data from every suitable study so no cherry picking in the end they created data from 11 studies involving over 90 000 subjects and it was shown that subjects who had had a previous heart attack gained a median of 4.1 days of life and those without a history of heart disease 3.2 days of life after taking statin drugs for years people gained between three and four days of life and understand there are reasons why this paper may even overestimate the benefits of statins first of all there have been many more studies on statins than were included in this review for the simple reason that the drug companies have not made the participant-level data available for independent analysis a problem that persists to this very day and this is a meta-analysis of randomized control statin trials published in february this year and it concluded that for those between the ages of 50 and 75 there is no mortality benefit in taking a statin interestingly enough only one of the eight studies they reviewed showed a positive effect known as the jupiter trial this one study actually excluded anyone with high ldl levels that's right it didn't even study the effect of statins on those with high ldl levels furthermore all subjects had to have a c-reactive protein level of at least two and understand that c-reactive protein is an inflammatory marker associated with heart disease and despite these limitations this is the one study that is continually recycled by those promoting statins seemingly content to ignore the findings of the other seven studies but staying with the jupiter trial i'd like to look at a way in which the reporting of studies can make the results look a whole lot more impressive than they really are the reporting on the jupiter trial was sensationalism at its best for example this newspaper article reported that study subjects taking a statin were almost 50 percent less likely to suffer a stroke need a stent or have bypass surgery sounds pretty impressive well let's take a closer look the outcome was a mashed up composite of five conditions which is a problem in itself these were non-fatal heart attacks non-fatal stroke hospitalizations for angina cardiac death or receiving arterial revascularization and it must also be noted that just because someone is subject to arterial revascularization which means getting something like a stent it doesn't necessarily mean it was warranted nonetheless using this mashed up composite endpoint the jupiter trial saw what was described as a 44 reduced risk with statin use so what does this 44 relative risk reduction mean in real terms well over the course of the study one and a half percent of those in the statin group and 2.7 percent of those in the placebo group met the criteria for the composite endpoint and compared directly side by side yes 1.5 is indeed 44 percent less than 2.7 to show it in absolute terms though i've graphed it here and when you look at it in absolute terms it's quite unimpressive and here i've graphed the data for heart attacks both fatal and non-fatal which is a much better outcome and you can see the difference between the two groups from the jupiter study is vanishingly small and yet this could be reported as a 54 reduced relative risk now consider for a second what would happen if we flipped this kind of mischievous reporting on its head if rather than reporting on the absolute rate of side effects of statins we presented the data as relative risk let's look at the study referred to in this newspaper article the heading suggesting that statins don't affect memory well out of a group of 480 000 odd statin users 376 of them reported acute memory loss compared to 114 in a matched non-statin user control group this represents a 320 increased risk of memory loss and when confounding variables were taken into account the risk of acute memory loss increased to 440 percent greater i wonder why the new york times didn't have the headline statins quadruple risk of memory problems i guess the take home message is don't get your health information from a newspaper the problem is as you'll see in my next lecture getting your health information from a doctor may sometimes not be much better in some cases doctors can feel coerced to do things such as prescribing statins against their better judgment at the end of the day remember you have the right to question your health care professionals and to ask them for the evidence on which they base their advice personally i expect nothing less from my patients thank you [Music] you

Channel: Low Carb Down Under

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Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Low Carb International All Stars 2021, Paul Mason, Low Carb Doctors, Statins

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Length: 13min 39sec (819 seconds)

Published: Sat Nov 20 2021