INDICES> statins and rhabdomyolysis (2)

["Randy Trinkle" <rtrinkle@gumby.citytel.net>]

INDICES> INDICES> statins and rhabdomyolysis (2)
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I think that the reaction to the withdrawal of cerivastatin (in the
context of disputing the benefit of statins) has been a bit over the
top.

I wouldn't dispute the influence of big pharma in promoting their
use, but there is certainly better evidence for benefit (in terms of
hard outcome data) than there is for other pharmacological
interventions.  Certainly diet and exercise have an important place
in cardiovascular health - and not just because they can improve
the lipid profile.  But - (1) the patient has to buy into making these
changes, and (2) these interventions may not be sufficient.  And in
fact - at least in people who have established cardiovascular
disease - they are probably not sufficient at all.  And the
possibility
that someone may be able to take a medication instead of making
lifestyle changes does not make the effectiveness of statins any
less.  People will only do what they are willing to do.  And quite
frankly there is no evidence that putting someone on a statin will
then allow them to continue lolling on the sofa stuffing themselves
with chips and gravy without a worry in the world.

I believe that hyperlipidemia most certainly needs to be treated
much more aggressively - and it's quite reasonable to promote diet
and exercise first over drug therapy.  And I agree that the number
of people who will suffer life-threatening rhabdomyolysis will
increase if the number of people prescribed a statin increases.  It
should not, however, be that difficult to target people most likely to
benefit from this therapy.

Statins do not confer a treatment benefit solely because they
improve the lipid profile.  They also reduce the risk of suffering an
MI by plaque stabilization, restoration of normal endothelial
function, and reduction of inflammation.  They may also prove to
reduce the risk of developing NIDDM.

Other pharmacological interventions do not have this scope of
effect and are simply not comparable.


*******************************
Randy Trinkle, BScPharm BA
Clinical Pharmacist
Prince Rupert Regional Hospital
Prince Rupert, BC
Health Science Links:
http://www.rupert.net/~rtrinkle
mailto:rtrinkle@mail.citytel.net


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