by Jock Rayment
This article found on the Times website, outlines how the combination of statins, a well-known treatment taken by an estimated 6 million Brits, along with a new “breakthrough” drug named Evolocumab can supposedly reduce the risk of heart attack. The opening paragraph begins by stating the claims from a trial that “people could cut the risk of a heart attack or stroke by a fifth with cholesterol lowering drugs”. This is potentially misleading as readers may assume this is in reference to the newly approved Evolocumab, when in fact it is most likely referring to a cocktail of several different drugs. Additionally, since we are given no further details of this “trial” such as the sample size or even who conducted the pharmaceutical trial, we must take care in how much weight we place on these statistics.
The second set of statistics the article includes is that “levels of “bad” cholesterol fell by 59%” in patients taking the statin-Evolocumab combination. However, it is well known that an individual’s levels of “good” cholesterol are equally, if not more, important in indicating the risk of cardiovascular disease. Since there is no information provided on the drugs’ effect on “good” cholesterol levels, we cannot conclude that this is a positive effect of taking Evolocumab and statins in conjunction. Furthermore, it is stated that this particular finding comes from an international study, which, due to significant disparities in life styles and diets across different cultures, may mean that this statistic is not generalisable to Britain.
It can also be argued that the 1.5% difference found between the placebo condition and those on the drug combination in cutting the risk of heart problems, is not significant enough to be deemed “the most important advancements” in fighting heart disease. Although there is no statistic given of a control group comprised of participants taking neither a placebo or the statin-evolocumab concoction, it a possibility that the placebo effect was enough to reduce the risk of heart problems in patients alone. It is also crucial to note that it took a relatively large sample size of 27500 patients in order for a weak but statistically significant benefit to be found.
Throughout the article, a Professor by the name of Peter Sever, makes several claims about the benefits of this new drug, including the fact that it has done “far and away more than any statin has ever done”. He also concludes that the findings of trials involving the new drug combination is a “huge breakthrough”, adding “new dimensions for patients” suffering from heart disease. It is these hyperbolic phrases that prompted me to do my own research into the clinical background of Professor Peter Sever. Upon further investigation I found that although a highly cited researcher, all of Sever’s past research has been funded by Pharmaceutical companies. This raises concerns surrounding Sever’s motives for such strong endorsement of the drug, as it would be of benefit to the pharmaceutical company to promote the drug, and in Sever’s best interest to appeal to his funders.
Interestingly, in the comments and discussion area at the end of the article, the author of the piece, Mark Porter, points out that lifestyle interventions post-heart attack such as the mediterranean diet, has an effectiveness of preventing 1 in every 18 heart attacks, a statistic far superior to the use of cholesterol-lowering drugs. Had this statistic been included in the original article, I believe it would have provided a much more balanced and informative argument.
In conclusion I believe the claim that the drug “prevents cardiovascular disease” is hyperbolic and sensationalised, a more appropriate claim would be so say that the combined effect of taking the two drugs (statins and evolocumab) marginally reduces the risk of cardiovascular disease in those with an already existent heart condition.