Free speech vital in statin debate

I recently returned from a whistle-stop tour of Australia where I gave a series of public lectures arguing that excess sugar consumption leads to chronic conditions such as type 2 diabetes and obesity. It was great to get an opportunity to appear on national TV, talking to Emma Alberici, host of Lateline on Australian Broadcasting Corporation and spread the message to viewers. She told me that Australians are now consuming around 26 teaspoons of sugar each day, which is pretty staggering when you consider that the World Health Organisation now recommends a maximum limit of six teaspoons of added sugar for an adult.  

There are no plans to introduce a sugar tax in Australia – like we will have in the UK – but at least, the debate about the damage that excess sugar can cause is happening. People are being given a chance to hear the arguments and make up their own minds.

Im afraid to say that Australians, and a large number of people in the UK and elsewhere around the world are not getting the same information about statins. I have long believed that statins, used to reduce high cholesterol,  are not the wonder drugs that we are lead to believe – largely through the dissemination of biased reporting in medical journals, commercial conflicts of interest and medical curricula that fail to teach doctors how to understand and communicate health statistics.  As a responsible cardiologist, I do prescribe statins to people at high risk of heart disease, but I have not seen any convincing data that statins are helpful for those patients at low risk of heart disease. In fact for these people, the emerging evidence suggests at best the benefits of statins have been grossly exaggerated and side effects underplayed. A recent paper published in JAMA concluded nearly 43 per cent of people taking atorvastatin over 10 weeks suffered side-effects compared to 26 per cent of those on dummy pills, a 61 per cent increased risk.

 And even for high-risk patients, the benefits appear to have been grossly exaggerated. The median increase in life expectancy in those at high risk who have suffered a heart attack if they take this pill on a daily basis for five years is a mere four days.

Much of the problem lies with how data about statin trials is controlled. I have deep misgivings about the fact the Clinical Trials Service Unit (CTSU) at Oxford University, which have allegedly received over £200 million in research funding from pharmaceutical companies that manufacture the drug, refusing to call for the release of raw data on statins for independent scrutiny. It is these industry-sponsored studies that have resulted in the prescription of statins to tens of millions of healthy people worldwide driving a multi-billion dollar industry.

And wider debate now seems to have been stifled. I object in particular to the bullying and harassment of people such as Dr Maryanne Demasi, the journalist behind the ‘Heart of the Matter’ investigation that highlighted the systemic lack of transparency of the clinical trial data regarding efficacy and side effects of statins.

For some inexplicable reason, the Medical Journal of Australia (MJA) published a paper claiming that her programme, which aired in 2013, may have resulted in up to 2,900 people suffering a heart attack or death from stopping their medication. Her documentary was then taken off the airways.

In my view, the paper was grossly misleading. Not only did it make extrapolations from industry sponsored data it provided no evidence whatsoever of increasing hospital admissions or recorded deaths to back up such claims.

When I was in Australia, I spoke up for her on radio publicly and in three different university lectures where the audience gave her rapturous applause as I campaigned for the banned documentary to be reinstated.  So far, it languishes on Youtube, but I am confident that Dr Demasis message will be heard, even if we have to rely on viral media.  Her courageous journalism has opened the eyes of doctors and the public around the world and I have no doubt that tens of thousands of patients quality of life may now have improved as a result of coming off statins or at the very least reducing the drug dosage.

The immediate past president of the Royal College of Physicians and former Queen’s doctor for 21 years, Sir Richard Thompson also supports its reinstatement. Maryanne Demasi rightly questioned the lack of transparency of patient-based data in commercial trials, and the impartiality of medical experts funded by the pharmaceutical industry, he told me: My conclusion is that a truly independent review of the scientific basis for the use of statins is now needed.

Dr Aseem Malhotra
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Mandi Smallhorne
Mandi Smallhorne
5 years ago

Thank you for putting it so simply and clearly. I am saving that one specific comment, about the four-day extension of life expectancy, to share with at-risk patients who feel bullied when they refuse to take statins.

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