Business, Economics, Health, Media Criticism, Science And Society, Technology and Society

A New Class Of Cholesterol Drugs

9 Comments

I wish I had more confidence that they’re not just treating a symptom:

As for the efficacy of the drugs, it is not yet proved that very low LDL levels produced by drugs lead to sharp reductions in heart attacks, strokes and deaths from cardiovascular disease, as researchers have seen in people with the naturally inactive PCSK9 gene.

Many cardiologists, though, are persuaded by a large body of evidence supporting the idea that the lower the LDL, the lower the risk.

“I believe lower is better and do not believe that a very low LDL is harmful,” said Dr. Daniel Rader, a cardiologist at the University of Pennsylvania.

Others, like Dr. Harlan Krumholz, a cardiologist at Yale, urge caution. “We are in a period of exuberant enthusiasm about these drugs,” he said. “We could just be performing cosmetic surgery on a lab value.”

If it were certain that the PCSK9 inhibitors were safe and effective in preventing heart attacks and deaths there would be no need for clinical trials, he noted.

$14,000/year is a lot of money for a treatment for which we have no idea whether or not it’s effective. I think improving diets would be much more cost effective.

[Update Tuesday morning]

Here’s a longer piece about the new drugs and the issues. Note: 1) It is assumed that the goal is to lower cholesterol, and that this will in turn result in lower mortality and 2) No mention of diet as a potential solution. Of course, it’s hard to get people to change their diets. But I suspect that to the degree that doctors are telling people to do so, they’re still telling them to cut out sat fat and cholesterol, despite all the actual science, and probably still telling them to follow FDA food-pyramic advice, which is junk science.

[Bumped]

9 thoughts on “A New Class Of Cholesterol Drugs”

  1. If you mean improving diets to lower cholesterol, from what I have seen and talked about with my internist (and my physician-wife), diet has only a minor role in serum cholesterol in most people.

    As for diet affecting cardiac health, more and more of the cardiac researchers are coming around to lower carb diets as being key, Not as low as Atkins, but lower than the US food pyramid would have you eat.

    1. Speaking personally, when I cut back on carbs my total cholesterol went down, my HDL/LDL ratio improved dramatically, and my triglycerides were almost immeasurable.

      1. Agree with you Rand. I was getting nervous that our generation was rapidly becoming the “guinea pigs” for statins and whatever long term effects there are in putting your liver into overdrive. That and the inconclusive science behind cholesterol and heart disease. So I took a break. Removing carbs and synthetic sugars from the diet and going full bore on the exercise. Although the LDLs are reading higher in the blood test, they and the triglycerides are staying outside the redlines. With the added benefit that the HDLs are now back at “healthy” levels. FWIW. And I can’t help but think my liver is thanking me…

      2. Speaking personally, when I cut back on carbs my total cholesterol went down, my HDL/LDL ratio improved dramatically, and my triglycerides were almost immeasurable.

        Rand, I’ve long been a believer in lower carbs, but I also believed the notion that it could lower cholesterol was preposterous.

        However, my personal results are the same as yours. It was one of many times in my life when I’ve been delighted to be wrong. 🙂

      3. I had the same experience, Rand. When you consider that excess carbs are turned into saturated fats inside your body, you have to wonder why those are supposed to be better than dietary fats.

  2. The real question is what happened to this?:

    https://en.wikipedia.org/wiki/ApoA-1_Milano

    Touted as “Health: Drano For The Heart”:

    When they signed up for this week’s annual conference of the American Heart Association in Orlando, Fla., thousands of doctors, scientists and pharmaceutical-company reps knew that they would be hearing about the very latest research into the causes of heart disease and the potential treatments. What they probably didn’t suspect was that the meeting rooms and hallways would be abuzz with news that broke before the gathering even began–news that may signal an entirely new approach to fighting the nation’s leading cause of death.

    By infusing patients with an experimental drug, reported Dr. Steven Nissen of the Cleveland Clinic in last week’s Journal of the American Medical Association, he and his colleagues reduced the fatty arterial plaque that triggers most heart attacks by an average of 4.2%–about 10 times better than statins, the most effective drugs now on the market, and in the almost unbelievably short period of just five weeks. With only 47 patients, the study was too small to be definitive, but, says Dr. Daniel Rader, the University of Pennsylvania cardiologist who wrote an accompanying editorial in J.A.M.A., “it’s very exciting for the field. It’s something that I think no one expected. It really has everyone scratching their heads.”

    http://content.time.com/time/magazine/article/0,9171,1006154,00.html

    Funny how nothing seem to come from it and we are still messing around with Statin drugs

    1. The answer is found in the Wikipedia article you linked: the drug has to be administered intravenously, and is expensive to make. That’s a non-starter for chronic disease treatment.

  4. From what I understand, lowering cholesterol is not only irrelevant, but it treats the symptom and not the cause.

    The cause may stem from years of low-level systemic inflammation that eventually cause the arteries to crack. Cholesterol gets into these cracks and builds up. So by reducing inflammation, we eliminate the wear on the arteries.

    http://www.marksdailyapple.com/what-is-inflammation/#axzz3kbPdajwk

    http://www.marksdailyapple.com/how-to-tell-if-youre-inflamed-objective-and-subjective-inflammatory-markers/#axzz3kbPdajwk

Comments are closed.