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Cholesterol Drug Cuts Heart Risk in Healthy Patients


4 Star

Cholesterol Drug Cuts Heart Risk in Healthy Patients

Our Review Summary

This story described the results of the JUPITER study which found that use of the statin medication Crestor reduced the risk of heart-related death, heart attacks and other serious cardiac problems in people who would be calculated to be at low risk of these but who had elevated levels of C-reactive protein.

The story met most of our criteria, but could have emphasized that the findings are those of a single study and that results need to be replicated before they can be assumed to have widespread application.  It also could have mentioned that there have been other studies with less expensive drugs with similar results.  

It is good that the story included skeptical comments from editorial writer Hlatky, something that a surprising number of stories ignored or failed to include.

We are troubled by the high placement of the impressive-sounding 44% relative risk reduction figure, with the absolute risk reduction given later in the piece, but not juxtaposed to the more impressive-sounding statistic.  We think readers need more clear help processing such stats.

There was also only a brief mention of the troubling diabetes rate in the Crestor group.  


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

While the story included a calculation that suggested that the intervention was as cost effective as strategies screening for elevated LDL, the story failed to indicate the actual cost to the consumer.


Does the story adequately quantify the benefits of the treatment/test/product/procedure?


Although the story mentioned the number of people in the two study groups who had heart-related death, heart attacks and other serious cardiac problems during the course of the study, it could have a done a better job at clarifying that this represented a small percentage of affected individuals.  A more direct statement an juxtaposition of absolute versus relative risk reduction would have been helpful.

Does the story adequately explain/quantify the harms of the intervention?


The story indicated that there was an increased number of people taking Crestor who developed diabetes during the study.

Does the story seem to grasp the quality of the evidence?


The story mentioned that the results of the study were presented at a recent meeting and that the results of the study had been published.  It described that the study population was a group of 17,802 individuals, all of whom had elevated levels of C-reactive protein (CRP) and that it was a randomized study of individuals given 20 mg of rosuvastin (Crestor) compared with a placebo group.

Does the story commit disease-mongering?


The story did temper the enthusiasm for more testing and more treatment by including skeptical comments from editorial writer Hlatky.

Does the story use independent sources and identify conflicts of interest?


The story included comments from several individuals who were not involved in the study and provided some cautionary perspective about the implications of the study.  And while this piece relied heavily on comments from Dr. Ridker, the story did mention that he was an inventor of the test for CRP was also the recipient of funding from the manufacturer of the study drug.

Does the story compare the new approach with existing alternatives?


The two main issues in the study reported on was the use of CRP to identify candidates who could benefit from lipid lowering  and then the use of Crestor to lower lipids in these individuals to lower cardiovascular disease risk.  In terms of treatment options,the story indicated the uncertainty about whether the outcomes observed were the result of the specific drug study or could be obtained with the use of any in the statin class of drugs.  It also mentioned that the reduction in CRP was not associated with the decrease in LDL levels seen in the study participants.  There was no discussion, however, about what, if any, other means for lowering CRP were available.

The story did mention that there was little known about what the long term impact of maintaining very low levels of LDL cholesterol.

Does the story establish the availability of the treatment/test/product/procedure?


From the story, it was clear that Crestor, the medication reported on, was currently available.  In addition, the story indicated that it did not have FDA approval for use in the way it was employed in the study.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story reported that the study indicated a new target population for a medication that was currently approved for use. However, the story failed to note that other studies (e.g. AFCAPS) have found benefit from lipid lowering in patients with no history of heart disease and non-elevated LDL levels, using the statin lovastatin, a drug with is now available as generic. The reductions reported were somewhat smaller, but not radically different.

Does the story appear to rely solely or largely on a news release?


Does not rely exclusively on a press release.

Total Score: 8 of 10 Satisfactory


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