11.06.14
Leading doctors urge NICE to scrap plans to extend use of statins
Proposals that would extend the use of statin drugs to millions more people to help lower cholesterol levels and reduce the risk of heart attacks and strokes should be scrapped, say a group of eminent doctors.
In February, the National Institute for Health and Care Excellence (NICE) published draft guidance calling for the threshold for offering statins to people to prevent cardiovascular disease (CVD) to be halved.
Currently, only people with a 20% or greater 10-year risk of developing CVD are offered statins. The draft guidance now recommends offering statins to people who have a 10% or greater 10-year risk of developing CVD.
However, the group of health experts, including Sir Richard Thompson, president of the Royal College of Physicians, and Professor Clare Gerada, past chair of the Royal College of General Practitioners, claim in an open letter that millions of over-50s risk harming their health if they follow the new NHS guidance telling them to take statins.
In an open letter sent to NICE and health secretary Jeremy Hunt, the experts say: “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.”
The doctors also state that they are “seriously concerned” that eight members of NICE’s panel of 12 experts for its latest guidance have “direct” financial ties to the pharmaceutical companies that manufacture statins.
But NICE chairman Professor David Haslam states that its committees are made up of clinicians, patients and others with the skills necessary to help interpret sometimes complex data. “None of them have put their names to the recommendations to make money for themselves,” he said.
The doctors also noted their concern that the data driving NICE guidance on statins comes almost entirely from pharmaceutical company funded studies. They stated: “To conclude we urge you to withdraw the current guidance on statins for people at low risk of cardiovascular disease until all the data are made available.”
Prof Haslam added, though, that the guidance does not medicalise millions of healthy people.
“On the contrary, it will help prevent many from becoming ill and dying prematurely,” he said. “We recognise that strong views are held by some on both sides of the argument about the best way to use statins, but our job is to reach a balanced judgement. Concerns about hidden data and the bias that the pharmaceutical industry may or may not have are important issues and need to be resolved.”
NICE will publish its final recommendations next month, after a public consultation.
[4pm Update: The British Cardiovascular Society (BCS) has stated that the open letter sent to NICE regarding its draft lipid guidance, does not represent the views of the cardiovascular healthcare professionals in the UK.
Iain Simpson MD, consultant cardiologist and president at BCS, said: “It is essential for patients with known cardiovascular disease, where there is firmly established evidence for the benefits of medication, including statin therapy, to understand the importance of continuing their medication.
“In addition, those patients who may be at high risk of developing cardiovascular disease over their lifetime should consult with their healthcare professional. The Joint British Societies consensus recommendations (JBS3) www.jbs3risk.com recently published in Heart highlight the importance of total cardiovascular risk, not just cholesterol, over the lifetime of an individual and the benefits from early lifestyle interventions with diet, exercise, and smoking cessation.”
He added that the research also emphasises the importance of additional drug therapy where necessary including statins, based on the estimated risk and their benefits from intervention to the individual rather than an arbitrary threshold for drug treatment of a single risk factor, as suggested in the draft NICE guidance currently under review.]
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