Statins - side effects
Re: Statins - side effects
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
(I've told them about the typo.)
"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
(I've told them about the typo.)
Re: Statins - side effects
Yes, this is paywalled.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).
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.
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
Re: Statins - side effects
I recommend reading the section on "Search strategy and selection criteria".mjr wrote: ↑16 Feb 2022, 4:05pmYes, this is paywalled.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).
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.
Jonathan
Re: Statins - side effects
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?mjr wrote: ↑16 Feb 2022, 4:05pmYes, this is paywalled.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).
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.
Re: Statins - side effects
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?Jdsk wrote: ↑16 Feb 2022, 4:28pmI recommend reading the section on "Search strategy and selection criteria".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.
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
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
Re: Statins - side effects
This sort of thing?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.
viewtopic.php?p=1581871#p1581871Jdsk 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.
Jonathan
Re: Statins - side effects
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.Jdsk wrote: ↑16 Feb 2022, 4:52pmThis sort of thing?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.
viewtopic.php?p=1581871#p1581871Jdsk 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.
MJR, mostly pedalling 3-speed roadsters. KL+West Norfolk BUG incl social easy rides http://www.klwnbug.co.uk
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
All the above is CC-By-SA and no other implied copyright license to Cycle magazine.
- simonineaston
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Re: Statins - side effects
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
(on the look out for Armageddon, on board a Brompton nano & ever-changing Moultons)
(on the look out for Armageddon, on board a Brompton nano & ever-changing Moultons)
Re: Statins - side effects
I believe Atorvastatin gave me lots of muscle pains and cramps. Changed to Rosuvastatin and that has drastically reduced them.
Al
Al
Reuse, recycle, thus do your bit to save the planet.... Get stuff at auctions, Dump, Charity Shops, Facebook Marketplace, Ebay, Car Boots. Choose an Old House, and a Banger ..... And cycle as often as you can......
Re: Statins - side effects
Tried 'em.
Atorvastatin 80mg for ten years.
Never ever again, ta very much.
Atorvastatin 80mg for ten years.
Never ever again, ta very much.
Mick F. Cornwall
Re: Statins - side effects
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.
Re: Statins - side effects
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
"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
-
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Re: Statins - side effects
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.
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.
-
- Posts: 5814
- Joined: 18 Aug 2015, 7:05pm
Re: Statins - side effects
re the emboldened, it's not true.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.
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/