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‘Put bluntly: In these studies, placebo did as well, or better, than statins when it came to keeping patients alive. Not one showed a clear reduction in all-cause mortality. Some showed the opposite: more deaths on the drug.
This is not the story the public, or most of our colleagues, hear. Instead, statins are sold as life-savers, when the uncomfortable truth is that in several large, well-run trials, they failed the most basic test: prolonging life’
A call to my colleagues
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suggest the opposite, that patients may actually fare worse on drug than on placebo.
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And yet we continue to prescribe them reflexively, as though they were vitamin pills.
At the very least, we must stop pretending the cholesterol hypothesis is settled science. If anything, these ignored trials should force us to re-examine whether lowering LDL is the right target at all.
If you want to live
It sounds heretical, but here is what the numbers show: If you want to live longer, in trial after trial, placebo was the better bet than the statin.”
‘But like many dogmas in medicine, the cracks are there if you dare to look. And some of the most damning cracks are found in a set of randomized trials that rarely get mentioned in the statin narrative.’
These are the ignored trials. Left out of the widely-cited meta-analysis by Silverman et al, they tell a story that should shake every clinician who still reflexively reaches for a statin prescription.
The shocking numbers
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In the EXCEL trial, all three pravastatin dose groups (20, 40, and 80 mg/day) showed more CHD deaths than placebo.
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Example: 0.50 percent vs 0.20 percent CHD mortality, a 150 percent relative risk increase for patients on pravastatin.
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In DEBATE, mortality was higher on the statin: 18.1 percent vs 17.4 percent total deaths, and CHD deaths were also worse (7.5 percent vs 6.0 percent).
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In GISSI-HF, rosuvastatin did not reduce death in patients with heart failure. In fact, total mortality was 28.75 percent vs 28.13 percent, a 2.2 percent relative risk increase with Crestor.
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SEAS and CORONA fared no better: slight excess mortality on the drug side, with no life-saving signal.
And then comes the kicker: IMPROVE-IT, the largest ignored trial, with approximately 18,000 post-ACS patients. Adding ezetimibe to simvastatin reduced LDL a bit further but had no impact on total mortality (13.40 percent vs 13.56 percent).
Placebo as the “better choice”
e.g. of another fraud:
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