Forskare reagerar mot Big Pharmakampanj

Den 9 februari skrev jag om Big Pharmas pågående propagandakampanj för de skadliga statinläkemedlen. Nu har vännen Uffe Ravnskov och några forskarkollegor tillskrivit ett 40-tal medicintidskrifters redaktörer om denna skamliga kampanj. Jag tycker ni skall ta er tid och läsa hans brev som även innehåller en rad värdefulla länkar till olika forskningsstudier.

Lars Bern

PS.

Vi har bildat Riksföreningen för Metabol Hälsa för att arbeta för bättre behandlingsmetoder mot metabola sjukdomar och för en kost som inte gör oss sjuka överhuvudtaget. Stöd vårt upplysningsarbete genom att gå med i vår förening och köp boken om Den Metabola Pandemin.

Dear Editors

Our letter is not aimed at publication in your journal. It has been sent to you and to the editors of 40 other major Scandinavian and international medical journals to inform you about medical misinformation.

My co-authors and I think that the cholesterol campaign is the main cause of the crises in the health care system in many countries; not only because of the obesity and diabetes epidemics that started shortly after American authoritieswithout any scientific support had introduced the high-carb low-fat diet at the early eighties, but also because millions of patients and healthy people all over the world have been prescribed a drug with minimal benefit, if any at all, and with many serious side effects.

Recently, the editors of Circulation announced that they and the editors of 16 other cardiology journals were publishingan article that would appear in each of their journals claiming that the benefits of statins have been proven by “robust scientific advances, published in the pages of our journals” and have “fostered significant improvements that benefit individuals and society. The editors are dissatisfied because their “prodigious tool chest” has been questioned by “medical misinformation hyped through the internet, television, chat rooms, and social media. In many instances, celebrities, activists, and politicians convey false information”.

Their decision is most likely an attempt to neutralize our recent reviews and meta-analyses where we have documented that the cholesterol hypothesis has been solidly falsified and that statin treatment is of doubtful benefit and has many serious side effects. Some of us have shown that statistical deception creates the appearance that statins are safe and effective. Furthermore, three years ago, we have documented in BMJ Open that according to 19 cohort studies including more than 68,000 elderly people (>60 years) those with high LDL-cholesterol live just as long, or in 92% of the cases, longer than people with normal or low LDL-cholesterol. In the largest study patients on statin treatment were included, but again, those with the highest LDL-cholesterol lived the longest. Cardiovascular mortality was recorded in nine studies; in seven of them no association was seen; in two of them, cardiovascular mortality was highest among those with the lowest LDL-cholesterol.

Our paper was severely criticised in over 100 newspapers and journals all over the world, but none of our detractors could cite a study with opposite results. Instead, several reviews were published by the supporters of statin treatment repeating and repeating the usual arguments in support of statin treatment.

There are numerous other faults in the belief that lowering total cholesterol or LDL-cholesterol as much as possible will prevent coronary heart disease. For instance, people with low cholesterol become just as atherosclerotic as people with high cholesterol; high cholesterol is not a risk factor for women or elderly people; in the cholesterol-lowering trials there is no exposure/response; and on average, lowering cholesterol merely prolongs life for a few days, regardless of how much you take or how long. Furthermore, in several major reviews, statin proponents use deceitful if not criminal ways to support their view; for instance by use of misleading statistics, by excluding unsuccessful trials, and by ignoring numerous contradictory observations published by independent researchers. Therefore, we have published a review detailing all the fallacies and falsifications of the cholesterol hypothesis in Expert Review of Clinical Pharmacology. According to Taylor & Francis, which publishes over 100 other scientific journals, they published more than 10,000 open access papers during the year 2018. Our review was at the top of their list of the ten most down-loaded papers.

But according to Circulation, criticism of the cholesterol hypothesis and statin treatment is defined as medical misinformation hyped in the media. It is noteworthy that there is no mention of our papers, although it seems unlikely that the editors of 17 major cardiovascular journals are unaware of a paper that during a few months have been downloaded by almost 60,000 readers.

By coincidence, or to support the cardiology journals´ cholesterol lowering campaign, the Cholesterol Treatment Trialists Collaboration (CTT) published an article in the current (Feb. 02) issue of Lancet entitled ”Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials4, suggesting that up to 8,000 lives could be saved annually in the U.K. if everyone over the age of 75 received statin therapy. CTT had previously published a 2010 Lancet paper touting the ”Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials”, so the present article was largely a rehash of old data that is not available to anyone else for verification.

As many cardiovascular events may heal with minimal sequela or none at all, we consider mortality as the most important outcome. In the CCT paper the authors claim that the result was a 12% reduction in coronary mortality. However, according to webfigure 6 in the appendix (a section that very few read), the reduction of coronary and all-cause mortality was only 0.2% per year. In webfigure 6 the total number of death per year among the oldest was 850 (4.1%) in the statin/more groups and 869 (4.3%) in the control/less groups. This means that the number of participants in each group must have been 19,767 and 20,209, respectively, and the total number 49,834. Thus, as the difference between the two groups was only 19 deaths, it means that you have to treat 1040 patients for a year to prevent one death.

How many of these patients may suffer from serious side effects is debatable. According to the statin trials it is less than 0.1%, but this is highly incredible, because in most trials the authors have excluded those who suffered from side effects in a short run-in period before the trial started. Many independent authors have documented much higher numbers, and in the IDEAL trial, where a low statin dose was compared with a high dose and where no run-in period was included, almost 50% in each group suffered from serious side effects. This is not mentioned in the abstract or in the text; only in a table (table 4). Furthermore, when you download this paper, the tables are not included. I have therefore attached the full paper.

More comments to the Lancet paper have been published by Zoë Harcombe, and Malcolm Kendrick

Hopefully our papers may start a serious debate about what we consider as the greatest medical scandal in modern time.

Yours sincerely

Uffe Ravnskov, MD, PhD, Independent investigator, Lund, Sweden. Email: ravnskov@tele2.se

David M. Diamond. Professor, Department of Molecular Pharmacology and Physiology, Department of Psychology Center for Preclinical and Clinical Research on PTSD, University of South Florida, Tampa, FL, USA. Email:ddiamond@usf.edu

Kilmer S. McCully. Associate Clinical Professor, Pathology and Laboratory Medicine Service, VA Boston Healthcare System West Roxbury, Harvard Medical School, Boston, MA, USA. Email: Kilmer.McCully@va.gov

Harumi Okuyama. Professor, Faculty of Pharmaceutical Science, Nagoya City University, Mizuhoku, Nagoya, Japan. Email: okuyamah@kinjo-u.ac.jp

Paul J. Rosch. Professor of Medicine and Psychiatry, New York Medical College; Chairman of the Board of The American Institute of Stress. Email: stress124@optonline.net

Sherif Sultan. Professor of Vascular and Endovascular Surgery, National University of Ireland Galway; Chairman, Western Vascular Institute. Email: mrsherif.sultan@gmail.com