At odds Statins offer no real protection against heart attack Last month, I told you about the latest statin shockwave involving Vytorin and the failing grade it received in a recent study evaluating its effectiveness (2/21/08 eTip, subject line: "New recruits"). Not surprisingly, attention quickly shifted to other statins, and the question on the forefront of everyone's mind -- not to mention the cover of Business Week magazine -- was "Do cholesterol drugs do any good?" Now, you read the eTips three times a week, so I'm guessing chances are good that you're as skeptical as Dr. Wright and I are about patent medications. But, I've got to say, the answer to the statin question even surprised me. Thanks to Dr. Wright, I've known for years that statins aren't the miracle workers that Big Pharma makes them out to be. But I had no idea just how inflated that claim really is. To get a better sense of statins' effectiveness you have to look beyond the percentages the drug ads are always spouting out. The print ads for the drug claim that it helps reduce heart attack risk by 36 percent. But follow the asterisk next to that number down to the fine print at the bottom of the page and things get a whole lot less impressive. There it says "In a large clinical study, 3 percent of patients taking a sugar pill or placebo had a heart attack compared to 2 percent of patients taking Lipitor." Taking that statistic one step further, you get to the real story behind statins -- something called the "number needed to treat" or NNT. The NNT refers to the number of people who must take a drug (or undergo any other form of treatment) in order for one person to benefit. For Lipitor, one of mainstream medicine's go-to statins, the NNT is 100. That means 100 people have to take Lipitor in order for just one person to avoid a heart attack. And THAT means that the other 99 people get no protective benefit from the drug whatsoever. The truly scary part is that those numbers are the ones Pfizer is using to sell Lipitor -- several other recent estimates claim that the NNT for statins is as high as 250 (meaning, again, that 250 people would need to take statins in order for the drugs to prevent a heart attack in just one person). If you need a little help putting that figure into perspective, consider the hypothetical situation posed by a professor of clinical medicine at UCLA: "What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day…and that 249 would have no benefit? And that they could do just as well by exercising? How many would take that?" I couldn't have said it better myself. Granted, the article I read does say that the NNT for healthy lifestyle changes is also relatively high. But, unlike statins, those things have the potential to positively impact other aspects of your life and your health -- and that's a gamble worth taking. Source: "Do cholesterol drugs do any good?" Business Week, 1/17/08 | 
