Cholesterol & Statins : the controversy continues

Abstract

A recent widely publicised Lancet review of statin efficacy and safety data generated more controversy than it resolved. Led by Professor Rory Collins of Oxford University, the review claimed that the benefits of statins have been underestimated and the risks exaggerated. Claims of statin intolerance in up to 20% of patients, the review argues, are not supported by largescale evidence from randomised trials. In fact, Collins et al. claim that statin therapy is no less well tolerated than placebo. Collins further claimed that the controversy about statin intolerance and myopathy rates emerged only in the past 2 or 3 years as manufacturers began marketing newer and “very expensive” cholesterol-lowering agents, such as, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors for patients classified as statin intolerant. He also pointed out that industry has funded reports on statin intolerance, as in the case of the European Atherosclerosis Society’s report2 which, not only had funding from makers of PCSK9 inhibitors, but also had its meetings coordinated by a commercial entity funded by the manufacturers.