Shooting the messenger


A disturbing trend has emerged. Not content with using our money to saturate the airwaves with commercial messages touting the benefits of their wares, the drug companies and their allies have taken to smearing anyone who questions the values of their nostrums as not just misguided souls but killers.

A paper that appeared this month in the European Heart Journal exemplifies this trend. The authors concluded that negative news stories about statins in the Danish media caused patients to stop taking these drugs, resulting in a one in 100 increase in the rate of fatal heart attacks over a fifteen-year period.

The authors did not look at all-cause mortality, and therefore did not provide a shred of evidence that anyone’s life has been shortened by statin discontinuation. Nevertheless, an article in the New York Times asserted “A Danish study has found that new stories that focus on the risks or adverse events of statin drugs may lead people to stop taking the medicines, and probably contribute to increases in heart attacks and deaths.”

Other examples of this sort of thing abound. Two years ago, Doctor John Abramson of Harvard University published a paper in BMJ showing that statins provide no reduction in mortality for those at low risk of a heart attack. The paper ignited a firestorm of controversy, with Professor Sir Rory Collins of the Cholesterol Treatment Triallists’ Collaboration demanding a full retraction of the paper, telling the Guardian, “This has the potential to cause a very large number of heart attacks and deaths.”

And what was the point of contention that led Professor Collins to demand a complete retraction of the paper? Dr. Abramson’s paper, citing another study, had claimed that the rate of statin-related side effects was 18-20% when in fact the reported rate was 17.4%.

To their credit, BMJ refused to back down, although they did publish a correction which stated in part, “The primary finding of Abramson and his colleagues—that the Cholesterol Treatment Trialists’ data failed to show that statins reduced the overall risk of mortality among people with < 20% risk of cardiovascular disease over the next 10 years—was not challenged…”

Around the same time Dr. Abramson and his colleagues published their analysis in BMJ, the Australian science journalism television program Catalyst ran a two-part documentary, “Heart of the Matter,” produced and presented by Doctor Maryanne Demasi. Part 1, “Dietary Villains,” questioned conventional wisdom about the role of saturated fat in heart disease, and Part 2, “Cholesterol Drug Wars,” argued that the benefits of statins have been oversold and the harms downplayed. Once again, a firestorm of controversy ensued, with demands that the documentary be retracted. Australian Broadcasting Company health expert Doctor Norman Swan told ABC radio listeners “People will die as a result of the Catalyst program.”

The ABC’s Bureau of Audience and Consumer Affairs reviewed twelve complaints pertaining to the documentary. Their final report, which ran for 49 pages, could not document a single factual error on the part of Dr. Demasi and Catalyst, and dismissed eleven of the twelve complaints as without basis. The twelfth complaint pertained to the second episode only and was about a matter of emphasis – that the documentary did not consider the (unproven) possibility that statins for primary prevention of heart disease might provide mortality benefits for certain subgroups of patients. On that flimsy basis, the ABC withdrew both episodes, even though by their own admission they could not find any problems with the first one.

That was not the end of the matter. Last summer the Medical Journal of Australia published a study claiming that some 60,000 Australians had discontinued their statins as a result of the Catalyst documentary. Even thought the paper did not look at mortality data, the authors asserted “[T]his could result in between 1522 and 2900 preventable, and potentially fatal, major vascular events.” Australian science journalist Lara Sinclair told readers “The ABC may have contributed to the deaths of thousands of Australians.”

However, the MJA paper was based on the CTT’s 2005 meta-analysis, rather than the more recent 2012 paper, and the endpoint of major vascular events was not specified in advance. In a telephone interview, Dr. Abramson told me the MJA paper, which in effect accused Doctor Demasi and Catalyst of killing people, was “based on an invalid endpoint and using old data.” Will there be calls for that paper to be retracted? Don’t hold your breath.

Patrick Hahn
Patrick D Hahn is the author of Prescription for Sorrow: Antidepressants, Suicide, and Violence and of Madness and Genetic Determinism: Is Mental Illness in Our Genes? Dr. Hahn is an Affiliate professor of Biology at Loyola University Maryland.