Thread by @MaryanneDemasi

We have responded to a critique of our 2022 analysis on statins (published in @JAMAInternalMed)

The critique was written by physician, podcaster @PeterAttiaMD

Join in the #statin discussion on Substack 👇👇

maryannedemasi.substack.com/p/response-to-… @pbyrne82 @mjones110164 @DrPaulMason

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Too often, statin advocates will communicate a drug’s relative risk reduction (impressive number), without quoting the absolute risk reduction (trivial number), a practise we consider unethical (see graph)

The FOURIER trial was cited as evidence of benefit but it did not show a mortality benefit. In fact, there were more cardiovascular deaths and total deaths in the group taking the PCSK9 inhibitors compared to placebo, albeit not statistically significant.

Researchers recently “reanalysed” the data in the FOURIER trial, and found some deaths may have been misclassified. These authors concluded that the potential harm from the treatment is higher than initially reported @BMJ_Open bmjopen.bmj.com/content/12/12/…

A systematic review & meta-analyses of 54 trials using PCSK9 inhibitors, published in @Heart_BMJ, reported no reduction in total mortality or cardiac deaths despite dramatic reductions in LDL-C heart.bmj.com/content/105/15…

The problem with assuming that the benefits of #statins continue to accumulate over decades, is that it ignores the fact that statin harms also accumulate -- especially if the harms take years to manifest e.g. cognitive decline and diabetes mellitus.

Our own findings were confirmed by a 2023 metaanalysis of 60 RCTs of statins, PCSK9 inhibitors & ezetimibe (cholesterol-lowering therapies), which found no association between the degree of LDL-C reduction & cardiovascular or total mortality journals.lww.com/cardiovascular… @LDLSkeptic

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