The Science Media Centre describes itself as:
“an independent press office helping to ensure that the public have access to the best scientific evidence and expertise through the news media when science hits the headlines”(1).
A recent briefing by the Centre covered the proposal by NICE to extend the use of statins to a much greater number of patients. According to a report in the BMJ, six leading professors of cardiology and epidemiology stated their conviction that the evidence from trials amply justified their confidence that the benefits of statins outweighed any risks (2). It was somewhat surprising that the briefing was so heavily weighted on the pro-statin side of the argument. Fiona Fox, director of the centre defended this position on the grounds that:
“The “vast majority” of cardiac and statin experts believed that the evidence was overwhelming, she said, and it was not the centre’s job to provide a platform to a minority who did not and thereby project a false image that the debate was in equipoise when it was not…”
This stance really does beggar belief. It would appear that Ms Fox is not well informed about this topic and that as far as this issue is concerned the Centre has not provided a balanced perspective. A more accurate picture has been painted by Ben Goldacre in the BMJ when he wrote:
“On the one hand, we have clinicians and researchers insisting that no sane patient would refuse a safe simple treatment that reduces their chances of a heart attack by one in 200; on the other, we have clinicians and researchers insisting that one in 200 is a laughable and trivial benefit, which no sensible patient could ever care about(3).
Here are a few extracts from the responses in the BMJ which show that there is definitely not universal support for the NICE proposal on statins:
- “Medicalisation of five million healthy individuals. We believe that the benefits in a low risk population do not justify putting approximately five million more people on drugs that will then have to be taken lifelong, without knowing enough about the side effects……… It is a concern that 8 members of NICE’s panel of 12 experts have had direct financial ties to the pharmaceutical companies that manufacture statins” (4).
Sir Richard Thompson, President of the Royal College of Physicians and 7 others
- “I am in no doubt, both personally and from the reported experience of my patients, that statin side-effects are consistently under-reported. This occurs two ways; firstly, doctors airily dismiss symptoms reported by patients (“statins could not possibly cause that!”), and secondly it is unusual for well-recognised side-effects such as rhabdomyolysis or even non-specific muscle pains to be yellow-carded. In my view the potential severity of muscle symptoms justifies extreme caution” (5).
Andrew N Bamji Retired Consultant Rheumatologist
- “Putting approximately five million more people in the UK on drugs, that will then have to be taken lifelong, for primary prevention of CVD without knowing enough about the side effects is foolhardy. The data on side effects needs to be made public and scrutinised by well qualified independent assessors. My own epidemiological experience of published results from industry funded studies comes from 3rd generation OCs and HRT. In each case there was strong evidence for industry bias in the published results“ (6).
Klim McPhersonVisiting Professor of Public Health Epidemiology, New College Oxford
One wonders why the Science Media Centre has allowed such a one-sided briefing. Could it be that there has been a failure to research the subject properly (eg by reading the BMJ and other reputable journals) or it has allowed itself to be unduly influenced by the pharmaceutical industry?. Whatever the reason, any reputation the Centre has established will have suffered.
If the Centre wishes to limit the damage then it must immediately have another briefing on statins which accurately reflects the current state of reliable information (not opinions!) on the benefits as a preventive measure, coupled with the genuine concerns about adverse side-effects.