tag:blogger.com,1999:blog-1732132352927731247.post5390264015401401224..comments2024-03-16T00:27:31.848-07:00Comments on Hooked: Ethics, Medicine, and Pharma: By JUPITER, Part II--A More Skeptical ViewHoward Brodyhttp://www.blogger.com/profile/00599587504924835039noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-1732132352927731247.post-28358128265473858972008-12-16T11:15:00.000-08:002008-12-16T11:15:00.000-08:00Ver mis comentarios enhttp://pharmacoserias.blogsp...Ver mis comentarios en<BR/><BR/>http://pharmacoserias.blogspot.com/Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-1732132352927731247.post-88371921822783421912008-12-01T20:03:00.000-08:002008-12-01T20:03:00.000-08:00Thoughts About those Darn HMG Co-A Reductase Inhib...Thoughts About those Darn HMG Co-A Reductase Inhibitors<BR/><BR/>With statins as a class of medications:<BR/><BR/>A.E.s are thought to occur more often than they are reported- with high dose statins in particular, yet with the type of statin administered possibly having a correlation with A.E.s as well, according to others.<BR/>Statins used with macrolide antibiotics can cause accelerated myopathy, it is believed.<BR/> Additionally, there is no reduction in mortality or increase in the lifespan of one on statin therapy, according to many. So caution should perhaps be considered if one chooses to prescribe such a drug for a patient. In other words, the health care provider should be assured that statin therapy for their patients is reasonable and necessary, of course.<BR/>Several risk factors should determine if one is placed on statin therapy, and not just one. High cholesterol is the apex of such therapy, yet other risk factors of the patient should be examined and evaluated as well by their health care provider, perhaps.<BR/>Statins do decrease CV events and CV risks significantly, it is believed. This may be due to the fact that statins increase endothelial function, stabilize coronary plaque, and decrease thrombus formation. Maximum reduction in LDL can be determined after about a month of statin therapy, others have said.<BR/>There is evidence to suggest that statins have other benefits besides lowering LDL, such as reducing inflammation (CRP) with patients on statin therapy, those with dementia or Parkinson's disease, and some forms of Cancer and cataracts, according to studies that have been conducted in the past.<BR/>It appears those statins that are produced specifically by fermentation, such as Zocor and Pravachol, have less incidences of myopathy than the other synthetic statins that exist. This may possibly due to fermented statins are believed to be much more hydrophyllic.<BR/>Yet overall, the existing cholesterol lowering recommendations should be re-evaluated, as they may be over-exaggerated, if one chooses to compare these guidelines with others in the past, there are possibly unreasonable expectations.<BR/>Finally, a focus on children and their lifestyles should be amplified so their arteries do not become those of one who is middle-aged, and prevent them from being candidates for statin therapy,<BR/><BR/>Dan AbshearAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-1732132352927731247.post-13977394282740522222008-11-16T06:39:00.000-08:002008-11-16T06:39:00.000-08:00Howard,As I unwind myself from a pretzel-like stan...Howard,<BR/>As I unwind myself from a pretzel-like stance (a week after my original post on JUPITER allows a more zen-like posture), allow me to reemphasize that my main concerns are cost and overall population health. Even if CRP is a good biomarker of CVD risk, its widespread introduction into general practice (your hypothetical patient walking in the door writ large) will add another substantial layer to health care costs in the U.S. . . to get to Ridker's 50,000 reduced CVD events per year (all, not just serious), it would add by my conservative estimate $6 billion a year in increased drug costs, even using generics. Double it for Crestor. How much CVD and diabetes could be prevented if we spent the same amount of money each year on diabetes prevention programs, which have been shown to cut progression to diabetes among high-risk patients by 50 to 70 percent. Diabetes actually increased in the JUPITER trial.Unknownhttps://www.blogger.com/profile/03761000500749152223noreply@blogger.com