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.
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."
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.
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.
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.
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.
The story did not engage in disease mongering.
The story included quotes from clinicians with different viewpoints and perspectives.
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).
The drug mentioned in the story, Crestor, was correctly reported to be FDA approved for elevated total cholesterol or LDL levels.
The story accurately captured the on-going discussion about whether long-term use of statin medications provides long-term benefit to the consumer.
Did not appear to rely largely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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