Statins - side effects

Jdsk
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Re: Statins - side effects

Post by Jdsk »

New study:

"Prevalence of statin intolerance: a meta-analysis":
https://academic.oup.com/eurheartj/adva ... 15/6529098
(may be paywalled).

Guardian coverage:
https://www.theguardian.com/society/202 ... tudy-finds

Jonathan
Screenshot 2022-02-16 at 15.30.58.png
(I've told them about the typo.)
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mjr
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Re: Statins - side effects

Post by mjr »

Jdsk wrote: 16 Feb 2022, 3:32pm New study:

"Prevalence of statin intolerance: a meta-analysis":
https://academic.oup.com/eurheartj/adva ... 15/6529098
(may be paywalled).
Yes, this is paywalled.

I've read other coverage this morning and because it is a meta-analysis, it is sand built on sand. Its conclusions on prevalence level should be regarded as shaky because of the poor methodology of many intolerance studies which fail to account for memory and other cognitive problems being among the adverse effects.

In my own case, I was incapable of remembering some of the problems I suffered, much less to link them to the statins. My GP at the time was a pompous ass and it took a locum GP to spot a link between likely onset of problems and start of statin use. If I had been part of a statin intolerance trial at certain points before that, I would probably have answered questionnaires that all was fine, simply because I had forgotten chunks of time where I had problems. After all, I kept taking the damned things until I could not stand up!

It definitely wasn't the "drucebo effect". Back then, I knew little of the side-effects except insomnia when starting use and I really thought they would work for me like they did for my father... but now I wonder whether they really worked for him because he did some pretty odd stuff near the end of his life... but we can never know.

I'm also a bit grumpy about Professor Smeeth quoted in the Guardian seeming to say that we should like statins partly because they are cheap. Firstly, that's not always been true (rosuvastatin was $260/month until a patent expired in 2016), and secondly, that's rather beside the point of whether they're safe and effective for a particular patient, surely?

Finally, it's interesting to see "exercise" among the side-effect risk-increasers on there, because I don't recall that being stated in any meta-analysis I've seen. I wonder what level of exercise that is and whether there's an increase of adverse effect risk with increase of exercise, which would have implications for cycle-tourists.
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Jdsk
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Re: Statins - side effects

Post by Jdsk »

mjr wrote: 16 Feb 2022, 4:05pm
Jdsk wrote: 16 Feb 2022, 3:32pm New study:

"Prevalence of statin intolerance: a meta-analysis":
https://academic.oup.com/eurheartj/adva ... 15/6529098
(may be paywalled).
Yes, this is paywalled.

I've read other coverage this morning and because it is a meta-analysis, it is sand built on sand. Its conclusions on prevalence level should be regarded as shaky because of the poor methodology of many intolerance studies which fail to account for memory and other cognitive problems being among the adverse effects.
I recommend reading the section on "Search strategy and selection criteria".

Jonathan
nez
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Re: Statins - side effects

Post by nez »

mjr wrote: 16 Feb 2022, 4:05pm
Jdsk wrote: 16 Feb 2022, 3:32pm New study:

"Prevalence of statin intolerance: a meta-analysis":
https://academic.oup.com/eurheartj/adva ... 15/6529098
(may be paywalled).
Yes, this is paywalled.

I've read other coverage this morning and because it is a meta-analysis, it is sand built on sand. Its conclusions on prevalence level should be regarded as shaky because of the poor methodology of many intolerance studies which fail to account for memory and other cognitive problems being among the adverse effects.

In my own case, I was incapable of remembering some of the problems I suffered, much less to link them to the statins. My GP at the time was a pompous ass and it took a locum GP to spot a link between likely onset of problems and start of statin use. If I had been part of a statin intolerance trial at certain points before that, I would probably have answered questionnaires that all was fine, simply because I had forgotten chunks of time where I had problems. After all, I kept taking the damned things until I could not stand up!

It definitely wasn't the "drucebo effect". Back then, I knew little of the side-effects except insomnia when starting use and I really thought they would work for me like they did for my father... but now I wonder whether they really worked for him because he did some pretty odd stuff near the end of his life... but we can never know.

I'm also a bit grumpy about Professor Smeeth quoted in the Guardian seeming to say that we should like statins partly because they are cheap. Firstly, that's not always been true (rosuvastatin was $260/month until a patent expired in 2016), and secondly, that's rather beside the point of whether they're safe and effective for a particular patient, surely?

Finally, it's interesting to see "exercise" among the side-effect risk-increasers on there, because I don't recall that being stated in any meta-analysis I've seen. I wonder what level of exercise that is and whether there's an increase of adverse effect risk with increase of exercise, which would have implications for cycle-tourists.
My own experience reflects yours closely. And Im afraid the subject has become so dirty my first response reading about a new survey or survey of surveys is, cui bono?
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mjr
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Re: Statins - side effects

Post by mjr »

Jdsk wrote: 16 Feb 2022, 4:28pm
mjr wrote: 16 Feb 2022, 4:05pm I've read other coverage this morning and because it is a meta-analysis, it is sand built on sand. Its conclusions on prevalence level should be regarded as shaky because of the poor methodology of many intolerance studies which fail to account for memory and other cognitive problems being among the adverse effects.
I recommend reading the section on "Search strategy and selection criteria".
Wonderful but that's inside the paywall, so us mere patients cannot see it. If you can see it, would you say that all the selected studies used methodologies that allowed for patients suffering cognitive problems?

And regardless, do you feel that it is appropriate for the "take-home message" to be for clinicians to "use these results to encourage adherence to statin therapy in the patients they treat"? That sounds an awful lot like continuing browbeating hesitant patients into compliance and telling them what they are suffering isn't real — and surely, if they think the problems are all in the patient's head, shouldn't they be referring them to mental health services?

Statins are normally used for chronic problems: it shouldn't be too detrimental to experiment at the patient level and randomly allocate different weeks or even months to statin or placebo use for a few periods to test whether reported adverse effects correlate with consumption and check whether the reports may merit further consideration. It certainly seems better than dismissing justified reports (the patient may be one of the 9-50%) or browbeating unaffected patients to the point they refuse treatment.
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
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Jdsk
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Re: Statins - side effects

Post by Jdsk »

mjr wrote: 16 Feb 2022, 4:49pmStatins are normally used for chronic problems: it shouldn't be too detrimental to experiment at the patient level and randomly allocate different weeks or even months to statin or placebo use for a few periods to test whether reported adverse effects correlate with consumption and check whether the reports may merit further consideration.
This sort of thing?
Jdsk wrote: 25 Feb 2021, 10:17am"Statin treatment and muscle symptoms: series of randomised, placebo controlled n-of-1 trials"
https://www.bmj.com/content/372/bmj.n135

Conclusions
No overall effect of atorvastatin 20 mg on muscle symptoms compared with placebo was found in participants who had previously reported severe muscle symptoms when taking statins. Most people completing the trial intended to restart treatment with statins. N-of-1 trials can assess drug effects at the group level and guide individual treatment.
viewtopic.php?p=1581871#p1581871

Jonathan
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mjr
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Re: Statins - side effects

Post by mjr »

Jdsk wrote: 16 Feb 2022, 4:52pm
mjr wrote: 16 Feb 2022, 4:49pmStatins are normally used for chronic problems: it shouldn't be too detrimental to experiment at the patient level and randomly allocate different weeks or even months to statin or placebo use for a few periods to test whether reported adverse effects correlate with consumption and check whether the reports may merit further consideration.
This sort of thing?
Jdsk wrote: 25 Feb 2021, 10:17am"Statin treatment and muscle symptoms: series of randomised, placebo controlled n-of-1 trials"
https://www.bmj.com/content/372/bmj.n135

Conclusions
No overall effect of atorvastatin 20 mg on muscle symptoms compared with placebo was found in participants who had previously reported severe muscle symptoms when taking statins. Most people completing the trial intended to restart treatment with statins. N-of-1 trials can assess drug effects at the group level and guide individual treatment.
viewtopic.php?p=1581871#p1581871
Yes, it's a useful treatment general protocol but that specific example is a flawed study because of its exclusions and the failure to allow for cognitive problems (participants had to self-report online, by phone or by post), so that conclusion cannot be generalised to the population in the way reports of it did.
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Mick F
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Re: Statins - side effects

Post by Mick F »

Mick F wrote: 24 Dec 2021, 9:09am Just had my 139th injection.
Once a fortnight, makes it nearly five and a half years. Still no side effects and when I've had a cholesterol blood-test, they don't even contact me with the results ....... so they must be fine.
Just had my 172nd injection.

Still no side effects.
Mick F. Cornwall
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simonineaston
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Re: Statins - side effects

Post by simonineaston »

No side effects is brilliant! I've been taking 20mg atorvastatin daily for a couple of months now and have no identifiable se, for which I'm grateful.
S
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Re: Statins - side effects

Post by al_yrpal »

I believe Atorvastatin gave me lots of muscle pains and cramps. Changed to Rosuvastatin and that has drastically reduced them.

Al
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Mick F
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Re: Statins - side effects

Post by Mick F »

Tried 'em.

Atorvastatin 80mg for ten years.
Never ever again, ta very much.
Mick F. Cornwall
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Re: Statins - side effects

Post by drossall »

drossall wrote: 6 Nov 2019, 1:38pm I'll try to read through this rather long but relevant thread later. I'm on 80mg Atorvastatin after a double heart bypass in early June. However, my GP has already said that he wants to trial a reduced dose in the new year.
As a more positive response, and an update on that, my GP did reduce me to 40mg in early 2020. I've been on that with no identifiable side-effects ever since.
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Re: Statins - side effects

Post by re_cycler »

Anyone care to take a shot at problems they can spot with this paper, the results are certainly eye catching.
"Death was postponed between −5 and 19 days in primary prevention trials and between −10 and 27 days in secondary prevention trials."
The length of trials duration is already identified and the potential errors introduced by the automated measurement technique of counting pixels under imported graph curves.

The effect of statins on average survival in randomised trials, an analysis of end point postponement.
https://bmjopen.bmj.com/content/5/9/e007118
LittleGreyCat
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Re: Statins - side effects

Post by LittleGreyCat »

Just noting that when diagnosed with Type 2 Diabetes I was put on statins because of the perceived cardiac risk.
I had a bad reaction to two variants (First one, could barely keep awake. Second one, angry all the time.).
I then came off statins.

My cholesterol has since been high, but the ratio of good<->bad has been acceptable.
Touch wood I haven't had any cardiac problems.
So I am not convinced that people always need statins, unless they already have cardiac/circulatory problems.

I have head that statins won't extend your life, just change what is on the death certificate.
No idea how true this is.

I have also heard that diabetics used to be put on statins because their risk of heart problems was the same as someone who had already had a heart attack.
More recently it has been realised that although the risk level may be the same, the causes are different so one treatment does not fit all.
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Re: Statins - side effects

Post by roubaixtuesday »

LittleGreyCat wrote: 12 May 2023, 7:48pm Just noting that when diagnosed with Type 2 Diabetes I was put on statins because of the perceived cardiac risk.
I had a bad reaction to two variants (First one, could barely keep awake. Second one, angry all the time.).
I then came off statins.

My cholesterol has since been high, but the ratio of good<->bad has been acceptable.
Touch wood I haven't had any cardiac problems.
So I am not convinced that people always need statins, unless they already have cardiac/circulatory problems.

I have head that statins won't extend your life, just change what is on the death certificate.
No idea how true this is.


I have also heard that diabetics used to be put on statins because their risk of heart problems was the same as someone who had already had a heart attack.
More recently it has been realised that although the risk level may be the same, the causes are different so one treatment does not fit all.
re the emboldened, it's not true.

In conclusion, statin use was associated with a significantly reduced risk of all-cause mortality in real-world cohorts


https://pubmed.ncbi.nlm.nih.gov/36233511/
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