X-Message-Number: 17389 From: "Mark Plus" <> Subject: "Rest easy, statin users" Date: Sun, 26 Aug 2001 11:31:42 -0700 http://www.usnews.com/usnews/issue/010903/health/stat.htm Science & Ideas 9/3/01 Rest easy, statin users Benefits dwarf risks for these cholesterol drugs By Avery Comarow Suppose you're on a medication that could cut the risk of having a heart attack by one third and the risk of dying from one by more than 40 percent. Then comes the news that the drug itself poses a 0.000017 percent risk of death. Would you stop taking it? Some would. Early last month, Baycol, a relatively new member of the powerful cholesterol-lowering class of drugs called statins, was withdrawn from the United States because of 31 deaths from rhabdomyolysis, a condition in which muscle tissue breaks down. That got some doctors' phones ringing. Then last week the Health Research Group, an arm of Ralph Nader's Public Citizen advocacy organization, called for the Food and Drug Administration to require the remaining five statins to carry bold warnings because they, too, occasionally cause rhabdomyolysis. The ringing escalated. "In the last couple of days we've gotten at least a hundred phone calls," cardiologist Alan Brown, medical director of the 5,000-patient lipid clinic at Midwest Heart Specialists in Naperville, Ill., said last week. Persuading some patients to stay on their statin, he lamented, "is like telling them to take arsenic." Comforting numbers. It has been known from the beginning that a few people on statins will develop rhabdomyolysis, es- pecially if they are taking certain other drugs. The Merck Manual, a basic physician's guide, emphasizes the risk with italicized type, naming several drugs to avoid. Baycol was considered especially risky. Yet many of the patients who died were on a high dose and were taking gemfibrozil, a cholesterol-lowering drug that should be shunned when taking any statin but especially Baycol, as both the Merck Manual and Baycol's labeling warn. For the five statins still on the market, however, the numbers are reassuring. Roughly 11 million prescriptions for Baycol had been written when it was withdrawn. From October 1997 to January 2001, nearly 300 million prescriptions were written for the other five, which the Health Research Group's statistics link to 385 cases of rhabdomyolysis and 52 deaths. That works out to less than 1 chance in 750,000 of getting rhabdomyolysis and 1 in 5,747,000, or 0.000017 percent, of dying from it. "The odds of a serious bleed from aspirin can be 1 in 50,000," observes Brown, who has had two rhabdomyolysis cases in 17 years both reversed by stopping the drug. Tragedy can almost always be headed off. "I warn patients all the time: 'If you have muscle aches and pains when you start this drug, call me,' " says Paul D. Thompson, director of preventive cardiology at Hartford Hospital in Connecticut. Unless, he generally adds with a grin, they climbed a mountain the day before. _________________________________________________________________ Get your FREE download of MSN Explorer at http://explorer.msn.com/intl.asp Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=17389