Crazy but true: they’re trying to sell drugs to healthy people

Get a Room!

I wish the Associated Press and JUPITER would get a room already so we wouldn’t keep stumbling upon their public displays of affection.

These two! Every few months we turn a corner and there they are, cozy as a couple of love struck teenagers.

Of course, by JUPITER I don’t mean the planet. I’m referring to the study titled “Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER).”

Notice that the researchers didn’t set out to “assess the use of statins,” they set out to present “justification for the use of statins.”

The study was sponsored by AstraZeneca, the maker of rosuvastatin (also known as Crestor), and among the 14 researchers who conducted the study, 10 received either “consulting fees” or individual grant support from AstraZeneca. So I think you can bet the house that this research was truly ALL about justification.

Meanwhile, the Associated Press is as smitten as a little schoolgirl.

Fantasy vs. reality

You’ve got to hand it to AstraZeneca execs – they’re gamblers. They took a long shot with the JUPITER study, hoping to show that their cholesterol-lowering drug would have benefits for people with high cholesterol AND low cholesterol, expanding their customer base to include…everyone!

Crazy idea, sure, but you can’t say they didn’t win over the AP.

This past November I told you about the first JUPITER results, published in the New England Journal of Medicine. The authors noted that subjects with low cholesterol who took Crestor “significantly reduced the incidence of major cardiovascular events.”

And the AP gushed, stating that the study was “hailed as a watershed event in heart disease prevention.” Yes, you can just imagine the celebration in the streets: people throwing their hats in the air, grown men weeping with joy…

Meanwhile, back here on earth, a close look reveals that the study actually suggests this modest result: If 120 people take Crestor for two years, only one heart attack, stroke, or death will be prevented. And those 120 people will each spend more than $1,200 per year on Crestor.

What a racket.

Round 2…

In addition to major cardiovascular events, JUPITER researchers also tracked the incidence of first occurrence of venous thromboembolism (formation of a blood clot that can block vessels).

After an average of about two years, venous thromboembolism occurred in 34 Crestor subjects and 60 placebo subjects. Of course, the researchers characterize this as a significant reduction of risk. And the AP chirps right in, stating that the results provide a new reason for people with normal cholesterol to consider taking a statin such as Crestor, Lipitor, etc.

But the difference between the two groups was only 26 events among nearly 18,000 subjects in the study. And some of these cases included patients who were at high risk of venous thromboembolism because of surgery or other health conditions.

So if your cholesterol is normal, are these modest numbers really going to inspire you to embrace statin use for the rest of your life?

Absolutely! Or that would be the response from Dr. James Stein who told the AP: “There are very few times you can say to a patient, ‘this medicine is going to keep you alive.’ We should try not to pick apart studies that save lives.”

Actually, we should try to pick apart EVERY study, Dr. Stein. Because sometimes you find the most interesting things. For instance, in the JUPITER study, new cases of diabetes and elevated blood sugar levels were markedly higher in the Crestor group compared to placebo. Crestor use has also been linked to a higher rate of life- threatening rhabdomyolysis (destruction of muscle) than other statin drugs.

The worst part: People who are perfectly healthy may be coaxed by their doctors into taking this drug – unaware they’re inviting risks they never dreamed of.

Sources:
“A Randomized Trial of Rosuvastatin in the Prevention of Venous Thromboembolism” New England Journal of Medicine, Published online ahead of print 3/29/09, content.nejm.org
“Study: Cholesterol Drug Lowers Blood Clot Risk” Marilynn Marchione, Associated Press, 3/29/09, ap.org