UP FRONT

THE ORGAN GRINDERS’ MONKEYS Beware of lazy journalists parroting corporate spin

WHAT METRO SAID: THE PILL TO STOP HEART ATTACKS by Finian Davern

A pill dubbed the ‘holy grail’ of medicine [1] could soon be given to

millions of patients to stop them having heart attacks. [2]

‘dramatically exciting’ results.

Nearly 350 heart patients [8]

The drug, Crestor, may also spell the end of heart bypass surgery

[3] because it is the fi rst to reverse the build-up of dangerous fat in

arteries. [4]

It could be given to healthy people as a supplement to prevent their

blood vessels becoming clogged. [5]

Researcher Dr Neal Uren said: ‘We have shown it is possible to turn

the clock back in the arteries of people with heart disease. This has

exciting implications.’ Heart disease kills 110,000 people a year in

Britain, while a further 200,000 survive heart attacks.

Until now, doctors thought it was possible to reverse the build-up of

atheroma [6] – fatty deposits which narrow the arteries and cause

heart attacks and strokes. But trials of Crestor, previously known as

an anti-cholesterol drug [7], produced what researchers are calling

in the US, Europe, Canada and

Australia were given eight times

the dose used to treat high

cholesterol. In 8 in 10 cases their

arteries improved. [9]

Side effects, such as severe muscle pains, affected one in 20 patients.

[10]

Dr Jay Wright, of Liverpool Cardiothoracic Centre, said: ‘The majority

of heart patients may no longer need heart bypass surgery.

‘If we can give them a pill in their 30s or 40s, their chances of having

a heart attack will be slashed.’

Crestor is made by drugs giant AstraZeneca, which said it expected the

drug to be used for the new treatment by ‘the fi rst half of 2007’. [11]

Metro’s uncritical reporting of Crestor

(rosuvastatin) amounted to little more than

a sales pitch for the manufacturer. Here’s

what they got wrong/omitted to mention.

[1] Crestor has never been dubbed a

‘holy grail’. The lead scientist of the

study, Dr Steven Nissen, was misquoted.

What he actually said was that, where

atherosclerosis – the blocked arteries that

result from the build up of atheroma,

or fatty deposits, on the artery wall – is

concerned: ‘The holy grail has always been

to try to reverse the disease.’

[2] There is no evidence that Crestor

prevents heart attacks. Indeed, Dr Nissen

has said that more research is necessary

to demonstrate whether the reduction of

plaque seen in this study actually lowers

the risk of heart attacks.

[3] There is no evidence from any

published trial that Crestor could prevent

the need for bypass surgery.

[4] All statin drugs have cholesterol

lowering effects. The dramatic results

achieved with Crestor in this small study

were due to the dangerously high doses

given to the study patients.

[5] There is no evidence that Crestor

is benefi cial or desirable in any way

for preventing clogged blood vessels

[atherosclerosis] in ‘healthy people’ – no

healthy people were included in the study.

Also Crestor is not suitable for everyone.

It should not be given to people of Asian

descent – they can experience a dramatic

and potentially dangerous build-up of the

drug in their bodies.

[6] It is not impossible to reverse the build

up of atheroma in the arteries. Medical

studies have shown that signifi cant

reversals can be achieved simply lifestyle

changes – such as a very low-fat vegetarian

diet, stopping smoking, stress-management

techniques and daily moderate exercise.

[7] Crestor is only indicated for use as an

anti-cholesterol drug. It is not licensed as a

treatment for atherosclerosis, so a doctor

prescribing it for this coition would be

engaging in the risky practice of off-label

prescribing – giving a drug for a condition

it was never intended to treat.

[8] The study originally involved 507

patients, not ‘nearly 350’. Of the 158 who

did not complete the trial, 62 dropped out

due to adverse effects.

[9] This is not accurate. In fact, just over a

third of patients experienced worsening

atheroma build-up while on Crestor.

[10] The trial was not large enough, did

not last long enough and did not include

a placebo group that would have allowed

the authors to accurately estimate the true

level of either benefi cial or adverse effects.

In fact, Crestor has been the focus of safety

concerns since its approval by the US Food

and Drug Administration in 2003. In an

editorial in the British Medical Journal in

October 2003, the Journal’s editor stated

that the manufacturer’s tactics, which

included a campaign of phone calls directly

to physicians, ‘raise disturbing questions

about how drugs enter clinical practice and

what measures exist to protect patients

from inadequately investigated medicines’.

A review in the Journal of the American

Medical Association in May 2005 concluded

that, compared with other statin drugs,

Crestor was 2 to 6 times more likely to

cause adverse effects. Crestor is associated

with serious problems, including myopathy

[progressive muscle weakness as a toxic

reaction] and rhabdomyolysis [a muscle

wasting disorder that can lead to kidney

failure]. Other adverse effects of note

include muscle pain, weakness, tenderness,

fever, dark urine, nausea and vomiting.

[11] By misrepresenting the safety and

effi cacy of the drug, [ital]Metro[ital] serves

the drug company rather than the reader.

The same day that reports of Crestor’s anti

plaque effects fi rst appeared in the news,

AstraZeneca’s share price rose by more

than 2 per cent – a boon for the company

in the face of speculation that a larger rival

might make a bid for the company.

THE ECOLOGIST 013