is a contribution from a member of THINCS,
The International Network of Cholesterol Skeptics
Letter to the editor of Lancet submitted on November 25,
2007 by Paulm Rosch.
Read also the editor´s answer below and Paul Rosch´ comments.
- In her review of statin safety (Nov 24), Jane Armitage noted an increase
in adverse effects with
"use of higher doses and interacting drugs".
Duration of treatment also increases the frequency and severity of
However, the goal of statin therapy to lower LDL below 100 mg/dl (and
70mg/dl for some patients) is difficult to achieve, which mandates taking
higher and higher doses for longer periods, if not perpetually.
is irresponsible and dangerous since the success of statins shows no
relationship to such LDL levels or how much LDL is lowered.1
In the CARE and WOSCOPS trials, no clinical benefit was observed in
patients with an LDL below 125 mg/dL2 or a greater than 24%
decrease in LDL.3
All statins are carcinogenic in laboratory animals at doses
equivalent to those used clinically.1
Cancer can take decades to surface but a significant increase in
malignancies apt to be detected early has already been reported, such as
skin cancer in the first two simvastatin studies and breast cancer in the
CARE and PROSPER trials.
makes no reference to these or other well-documented statin complications,
including cognitive defects, amnesia, heart failure, and peripheral
polyneuropathy.4 Since over 90 percent of significant drug side effects are
not reported and statin complaints are usually ignored by physicians, the
frequency and seriousness of adverse reactions to statins is undoubtedly
much greater than appreciated.
Markers of inflammation like CRP might be preferable to monitor
statin therapy, especially since their reduction does not correlate with LDL
1. Alsheikh-Ali AA, Maddukuri PV, Han H, Karas RH. Effect of the
Magnitude of Lipid Lowering on Risk of Elevated Liver Enzymes,
Rhabdomyolysis, and Cancer Insights From Large Randomized Statin Trials.
J Am Coll Cardiol 2007;50(5):409-418.
2. Sacks FM, Moyé LA, Davis BR, et al. Relationship between plasma LDL
concentrations during treatment with pravastatin and recurrent coronary
events in the Cholesterol and Recurrent Events trial. Circulation
West of Scotland Coronary Prevention Study Group. Influence of pravastatin
and plasma lipids on clinical events in the West of Scotland Coronary
Prevention Study (WOSCOPS). Circulation 1998; 97:1440–1445.
4. Ravnskov U, Rosch PJ, Sutter MC, Houston MC. Should
we lower cholesterol as much as possible? BMJ
5. Rosch PJ. Determining Optimal Statin Dosage. Mayo Clin Proc
is the answer from the editor (Paul Rosch´ comments in bold)
Dear Dr Rosch,
Thank you for submitting your letter. After in-house review, I'm afraid we
have decided not to accept it for publication. We regret that we are
unable to write a personal note for every letter we turn down, but the
following common reasons for rejection may help you with future
submissions: lateness (ie, more than 2 weeks after publication of the
article on which you are commenting) (the letter was sent within 2
weeks), inclusion of
original research (the section is not peer reviewed, so we cannot publish
such work here) (no original work was included in the letter), submission of case reports
a separate section for these)(it is not a case report), reiteration of points made by another
correspondent (no other correspondent has responded, and inappropriate length (limits are
250 words and 5 references) (the letter has 250 words and 5 references). If none of these apply
to your letter, please be assured that we have nevertheless considered it
carefully and probably had to refuse it because we have simply received
too much good material (No letters commenting Armitage´s review have
More unpublished contributions