Comments on: The Crestor Study Tells Us…? Mark Zucker Explains

By: Jim

Jim — Wed, 19 Nov 2008 15:45:41 +0000

Ms. Adams

I am not sure you will read this but if you I will first qualify my statements by advising you that I am not in the medical field.
The Jupitor studies have shown some benefit in reducing the number of Cardiovascular Events (CVE’s) during it clinical trials but at this time the use of Crestor has not been approved for use as a preventative of CVE’s. If your husband’s LDL chosterol levels are now under control, the number was 130 but now the medical profession is stating it should be at 70, then there is no current valid reason to prescribe any Statins.
As far as the CRP measurement is concerned, CRP levels have not yet been approved as a measure to determine the liklihood of a CVE, elevated CRP levels can occur for a variety of reasons.
You write that your husband’s family has a history of heart attacks and in my opinion, that is extremely important. However before starting on a life long regime of statin therapy at the age of thirty, I would seek a second opinion and also seek additional testing to determine if your husband is currently showing additional risk factors that would induce his physician to recommend that he begin statin therapy. If your husband’s doctor is recommending Crestor and Crestor only I believe he is jumping the gun and prescribing Crestor for an as of yet unapproved off label use of this drug.
However in defense of your husband’s doctor he did advise your husband that the drug has serious side effects so I am assuming he has looked at all of the factors I described above and he only mentioned the CRP readings because of the recent study but that is not his primary reason for prescribing the statin therapy.

By: Shareen Adams

Shareen Adams — Sat, 15 Nov 2008 03:10:00 +0000

My husband has a 4.1 CRP. He is 30 years old with a family history of high blood pressure and cholesterol. He just developed this in the past 2 years. Many men in the family have had heart attacks but also did not treat their health conditions. My husbands dr. wants to put him on this new medication, Crestor but says it is very strong with many side effects. I am not sure it is worth it. This is a new drug with not much history. I am very worried for my husband. Would you recommend he takes this drug? Is it worth it?

By: Nathan

Nathan — Tue, 11 Nov 2008 16:33:17 +0000

Seat belts have no side effects. Air bags would be a better example. They clearly have risk (child head trauma) and cost (~$300/car?) associated with them. Yet we clearly accept the “risk” in order to receive the benefit. Note that the vast majority of cars go to their grave without ever having deployed their air-bag. Was all that cost a waste?

Back to the topic at hand: I agree, it’s all a risk-benefit calculation. However, in your posts, you frequently allude to the low (absolute) benefit without noting the absolute risk is also very, very low. (however, I agree, there ARE risks)

By: S M

S M — Tue, 11 Nov 2008 14:36:27 +0000

Nathan wrote: “To clarify what I mean: By your logic, we shouldn’t bother wearing seatbelts because the absolute risk of dying by a car crash over a given 5 year period is very, very low.”

That’s not an equivalent analogy to increased statin use. Statins can have significant side effects, whereas wearing a seatbelt is by all measurements benign.

By: Doug Bremner

Doug Bremner — Tue, 11 Nov 2008 14:34:10 +0000

But wearing a seat belt has no side effects, Nathan. The question is true risk versus benefit. Interesting example though. Did you know that in the 1960s General Motors hired a hooker to try and entrap Ralph Nader because they were upset that he was trying to get them to put seat belts in cars? And look where they are now, getting ready for a tax payer bail out. How the mighty have fallen.

By: Nathan

Nathan — Tue, 11 Nov 2008 10:36:07 +0000

To clarify what I mean: By your logic, we shouldn’t bother wearing seatbelts because the absolute risk of dying by a car crash over a given 5 year period is very, very low.

By: Nathan

Nathan — Tue, 11 Nov 2008 10:34:37 +0000

Doug,
You like to harp on “relative vrs absolute risk”. But I’ll remind you that the absolute risk of many many things is quite low. Auto accidents, air crashes, drownings, food poisoning. The “absolute risk” of death and injury from all those events is very, very low. Yet, as a society we spends LOTS of money and effort in order to lower the “absolute risk” of those tragedies by very small amounts.

By: PaulGGG

PaulGGG — Tue, 11 Nov 2008 05:19:03 +0000

Problem is that CRP is totally non-specific. It goes up with anything and everything. You have a cold, CRP goes up. You exercise, CRP goes up. Many foods drive CRP up.

So how is anyone going to tell is someone has true vascular CRP elevation or just artificial?

By: Brian

Brian — Tue, 11 Nov 2008 04:47:38 +0000

Jim said…”In my opinion…” I could not agree with you more.

By: Jim

Jim — Tue, 11 Nov 2008 02:51:09 +0000

Doug

Thanks for the explanation, it appeared to me at least that the numbers presented in the Crestor Study did not demonstrate the need for increased statin therapy and your explanation validates my initial impression.
Also the study included individuals who smoked, suffered from metabolic disorder, came from families with a history of cardiovascular disorder, or were over the age of 65 and I was curious as to how many individuals from those groups suffered a CVE. I believe a closer look at these individuals will invalidate the study in its entirety and demonstrate that the risk associated with increased statin use definitely outweighs its benefits, but I won’t hold my breath waiting for that announcement.
In my opinion the study only demonstrates that the pharmaceutical industry will go to any lengths to expand their customer base.