Statinkrig inom det brittiska medicinska etablissemanget

Från min vän Uffe Ravskov har jag fått följande tänkvärda redogörelse för ett krig rörande statinförskrivning som brutit ut i Storbritannien. Jag hinner tyvärr inte översätta det. 
 
The media are finally waking, at least in the UK. On Tuesday 10th June a press release was sent to all the British newspapers with the title:Leading Doctors Reject Statin Guidance From The National Institute for Health and Care Excellence (NICE). You can read the press release in full below. It was commented the following day on the front page of the National Papers in the UK, for instance in
 
The Independent
The Telegraph
Express
Daily Mail
BBC News 
 
Malcolm Kendrick, one of our members and one of those who organized the protest against NICE, was also interviewed on BBC
 
A few days earlier Zoë Harcombe, another of our members, told about the many lies and misunderstandings around cholesterol and statin treatment on Radio Europe. Recently she also wrote about obesity and our diet in the Guardian
 
Read also The Truth About Statins by James Le Fanu in The Spectator

The press release:

An open letter has been sent to the chair of NICE and the secretary of state for health, Jeremy Hunt, from leading doctors in primary care, secondary care and academia. They reject the recent draft guidance from NICE to reduce the threshold for prescribing statins to those with a 10% risk of cardiovascular disease (potentially treating an additional five million healthy individuals).

The letter is signed by a number of leading figures in health including the president of the Royal College of Physicians, Sir Richard Thompson, Professor Clare Gerada, Past President of the Royal College of General Practitioners and Professor Simon Capewell, Clinical Epidemiologist at the University of Liverpool.

Other signatories include Professor David Haslam, Chair Of The National Obesity Forum, GP Dr Malcolm Kendrick, London Cardiologist Dr Aseem Malhotra and Professor David Newman, Emergency Medicine physician and Director of clinical research and Mount Sinai School of Medicine, New York.

They address six major concerns and call on NICE to refrain from any final recommendations on reducing the threshold for statin guidance until these are fully addressed.

     These six key areas are:

1. The medicalization of millions of healthy individuals

2.  Conflicting levels of adverse events

3.  Hidden data

4.  Industry bias

5.  Loss of professional confidence

6.  Conflicts of interest

The group state the benefits of statins in a low risk population do not justify putting millions of extra people on a drug which then has to be taken lifelong.

They also express serious concerns that the data driving the latest guidance comes almost entirely from pharmaceutical sponsored studies. Because extensive research reveals that industry sponsored trials systematically produce more favourable outcomes than non-industry sponsored ones. Industry trials also grossly underestimate adverse effects, partly by removing patients who fail to tolerate the drug in the selection process.  They state “relying on these studies alone will not represent those patients taking the drug in the real world.”

The group cite important findings from non-industry sponsored studies which include a 48% increased risk of developing diabetes in middle aged women taking statins, while a robust randomised controlled trial revealed that 40% of women had reduced energy and fatigue. Others experienced psychiatric symptoms or erectile dysfunction.

They call on the Cholesterol Treatment Trialists Collaboration who have commercial agreements with the pharmaceutical industry to release all data on statins which is currently being concealed for review by independent researchers to help explain major discrepancies in several industry sponsored studies of statin adverse effects.

The leading doctors also mention that GPs feel that greater prescribing of statins to healthy people is a “step too far” citing the General Practitioners committee’s rejection of NICE guidance a few weeks ago until it is supported by evidence derived from complete public disclosure of all clinical trials data”

The group express “serious concerns” that 8 of 12 of NICE’s panel of experts on latest statin guidance have direct financial ties to the companies that manufacture statins. They instead emphasise that parties with industry conflicts should NOT be participants in generating recommendations on drug use across the population.

 The leading doctors call on NICE “ to withdraw the current guidance on statins for people at low risk of cardiovascular disease until all the data are made available.”

They conclude: “The potential consequences of not withdrawing this guidance are worrying: harm to many patients over many years, and the loss of public and professional faith in NICE as an independent assessor. Public interests need always to be put before other interests, particularly Pharma.”

Professor Simon Capewell, Professor of Clinical Epidemiology at the University of Liverpool said,

“Two decades of research has confirmed the obvious: doctors receiving drug industry funding produce recommendations favouring the industry. It also represents a further embarrassment for NICE. NICE urgently need to develop a better mechanism for controlling these conflicts of interests. The recent statin recommendations are deeply worrying, effectively condemning all middle aged adults to lifelong medications of questionable value. They steal huge funds from a cash-strapped NHS, and they steal attention from the major responsibilities that government and food industry have to promote healthier life choices for ourselves and our children"

London Cardiologist Dr Aseem Malhotra said,

“Although there is good evidence that the benefits of statins outweigh the potential harms in those with established heart disease, this is clearly not the case for healthy people. For example a doctor wouldn’t give chemotherapy to a patient who didn’t have cancer or prescribe insulin to someone without diabetes. When you add up hospital appointments, unnecessary suffering for those who experience side effects that interfere with the quality of life, the illusion of protection of taking a drug that won’t reduce the risk of death in healthy people- and the increasing burden of chronic disease which is predominantly lifestyle related- prescribing statins to millions of healthy people would increase costs to the NHS, not reduce it. I became a doctor to practice medicine that’s best for patients based upon all the available evidence, independently evaluated, not medicine that’s purely eminence based or corporate influenced.”

Dr Malcolm Kendrick, GP and member of the British Medical Association’s General Practitioner’s sub-committee said,

“Who knew that millions of people in the UK now suffer  from statin deficiency syndrome? Mass statination is the triumph of statistics over common sense. Treating millions at a cost of billions, all based on data we are not allowed to see is another example of the corporatisation of medicine and will result in a public health disaster.”

Dr David Newman, Assistant Professor of Emergency Medicine and Director of clinical research at Mount Sinai School of medicine , New York said,

“I am always embarrassed when I have to tell patients that our treatment guidelines were written by a panel filled with people who stood to gain financially from their decisions. The UK certainly appears to be no different to that of the United States. The truth is for most people a statin will give them diabetes as often as it will prevent a non fatal heart attack—and they won't live any longer taking the pill. That’s not what patients are looking for.”

The full list of signatories:

Sir Richard Thompson, President of the Royal College of Physicians

Professor Clare Gerada, Past President of the Royal College of General Practitioners and Chair of London’s primary care board

Professor David Haslam, General Practitioner and Chair of the National Obesity Forum

Dr JS Bamrah, Consultant Psychiatrist and Medical Director of Manchester Mental Health and Social Care Trust

Dr Malcolm Kendrick, General Practitioner and Member of the British Medical Association’s General Practitioners sub- Committee

Dr Aseem Malhotra, London Cardiologist.

Dr Simon Poole, General Practitioner

Professor Simon Capewell, Professor of Clinical Epidemiology, University of Liverpool

 For all media and press enquiries please contact, Dr Malcolm Kendrick 07714 427 642, 01625 502 001 or Dr Aseem Malhotra 07786 075 842

Kategori: Hälsa
Taggar: Big Pharma statiner
1 Lars M:

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Som vanligt när massindoktrinering händer, FOLLOW THE MONEY!
En sak verkar väldigt klar, när masshysteri utbryter ska man ha is i magen, ifrågasätta alla självutnämnda experter, inte nöja sig med blahablahasvar.
Ett skrämmande exempel stavas IRAK...ett annat IPPC.
Samt vaccination mot fågelinfluensan....håhåjaja

3 Lars Bohman:

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Har liksom Lars Bern stått några år på Lipitor, dock utan att ha fått några uppenbara men. Efter att ha satt mig in i dokumentationen så satte jag själv ut preparatet mot min kardiologs inrådan. Det ska tilläggas att jag själv är läkare, och att mina behandlande kolleger som tjatade om medicinen alltid var sämre pålästa än jag själv. Det hindrade dem inte det minsta i deras argumentation. Vi läkare har en tendens att bli självgoda eftersom vi hela dagarna umgås med människor som vanligen vet mindre än vi om hälsa och sjukdom.

Jag gjorde nyligen ett halvhjärtat försök att i Läkartidningens kommentarsfält problematisera de nya riktlinjerna för statiner. Det blev snabbt nedsablat med statistisk mumbo-jumbo från professorskompetenta kolleger. Att de hade koppling till just statin-industrin noterade jag i förbigående.

Det "medicinska etablissemanget" - det vill säga den amerikanska läkemedelsindustrin och deras (!) läkarkår - har bestämt sig för att så gott som alla människor - friska som sjuka - har viss mätbar (=pytteliten) nytta av statiner, gärna i hög dos. De nya riktlinjerna är därefter. Glädjande nog har brittiska läkare haft modet att ifrågasätta detta - inte minst de tvivelaktiga metoder som man numera upptäckt att mångmiljardindustrin tillämpar i den farmakologiska forskningen. De har kommit att dominera totalt vad gäller finansiering av sådan forskning, som därmed blivit opålitlig och snarare att betrakta som en partsinlaga.

Det är få läkare som orkar ifrågasätta de etablerade sanningarna. Jag har som många andra blivit åthutade i hotfulla ordalag när jag ifrågasatt sådana sanningar på konferenser. Vill man har sin forskning finansierad så måste man hålla sig inom vedertagna gränser. Precis som om man vill forska om klimat eller kostvanor. Industri och politik är tillsammans mäktigare än det vetenskapliga etablissemanget, som ofta är totalt i händerna på sina båda finansiärer.

Det är ett nytt fenomen att ekonomiska och politiska intressen tillåts inkräkta på vetenskapens domäner. Det är inte utan att man längtar efter upplysningstidens vetenskapsideal - kanske också att en fransk revolution är enda vägen ut ur detta moras.

Svar: Jag håller med dig om att vi behöver en ny Upplysningstid. För det krävs en politisk ledare med samma kurage som Fredrik den Store som släppte fram religionsfrihet och upplysning med sitt yttrande att: må var och en bli salig på sin egen fason!
Lars Bern

2 Hans Högqvist

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Av en tillfällighet upptäckte en läkare, i ett forskningsprojekt om demens som jag deltar i, att min ena halspulsåder var förkalkad. Operation övervägdes men man tyckte att risken var för stor och medicinsk behandling med Simidon (som är ett statin preparat) sattes in med bra effekt. Detta var för tre år sedan. I samma veva flyttade min utmärkta allmänläkare från orten och jag hade några olika läkare som jag inte fick några vettiga svar från angående om jag kunde sluta med Simidon eftersom inga ljud hördes från någon förkalkning längre, de ansåg dock att jag borde fortsätta "för säkerhets skull". Nyligen har jag hittat en vettig läkare igen men har glömt ta upp detta med henne men det ska ske nu på måndag!
Än en gång har du väglett mig Lars, en gång angående bilbränsle och nu två gånger angående hälsa!
Jag tackar för en utmärkt och alltid intressant blogg!

Svar: Jag stod på statinen Lipitor i fem år. När jag började sätta mig in i vetenskapen bakom obefogade kolesterollarm och statiner slutade jag på eget bevåg. Kvar har jag nedsatt känsel i två fingrar som ett minne av detta förfärliga preparat.
Lars Bern