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Cholesterol drugs for the healthy still debatable

Rating

4 Star

Cholesterol drugs for the healthy still debatable

Our Review Summary

 This story raises insightful questions about the use of a particular statin medication, Crestor, in a patient population without elevated cholesterol levels.  The story mentioned that a company financed study demonstrated benefit from the use of this drug in a cohort of individuals with modest LDL levels (<130) but who had elevated levels of C-reactive protein and contrasted that with a recent review which found that while the drug did further lower LDL level, it did not appear to confer benefit in terms of helping patients live longer.  The story was useful for helping raise reader awareness to question the value of the particular study endpoints reported.

 

Why This Matters

 The final quote of the story is the take-home point:  "We just don’t know what the balance of benefits and harms are for people who are going to take this for a lifetime." 

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story included Crestor sales figures but did not tell readers how much it cost consumers.  Unlike some of the other statin medications, Crestor is not yet available in a generic form and thus is one of the more costly statin medications.

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

Satisfactory

 The story raised questions about the benefits to be obtained with the use of this medication by individuals who do not have elevated cholesterol but who may have elevated levels of CRP.  It mentioned both the cholesterol lowering capacity of the drug and the question of whether it had any impact on how long a person lived.

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

Satisfactory

The story raised the question about the appropriateness of recommending a drug for long-term use when the study which is the basis for its recommendation monitored people for only two years.  "Too little attention is paid to potential risks, such as developing diabetes" – was a short explanation.

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

Satisfactory

The story questions evidence generated by a study underwritten by the company which sells the drug. The story questioned the merit in a 2 yr. decrease in cholesterol levels in light of there possibly being no associated increase in longevity.

And it gave a brief overview of three new papers in the Archives of Internal Medicine.

Does the story commit disease-mongering?

Satisfactory

 The story did not engage in disease mongering.

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

Satisfactory

 The story included quotes from clinicians with different viewpoints and perspectives.  

Does the story compare the new approach with existing alternatives?

Not Satisfactory

 The story did not delve into the realm of whether this statin medication is really any different than other statin medications.  So many stories about the JUPITER trial and now this followup analysis only mention Crestor but don’t explain whether this is a "class-effect" issue affecting all drugs in this class. 

In addition, in terms of alternatives, the story could have included at least a line about the appropriate context for the use of these medications (i.e. in combination with a heart healthy diet and lifestyle).

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

Satisfactory

 The drug mentioned in the story, Crestor, was correctly reported to be FDA approved for elevated total cholesterol or LDL levels.

Does the story establish the true novelty of the approach?

Satisfactory

 The story accurately captured the on-going discussion about whether long-term use of statin medications provides long-term benefit to the consumer.

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

Satisfactory

 Did not appear to rely largely on a news release.

Total Score: 8 of 10 Satisfactory

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