Smertefulle bivirkninger i musklene (apollon.uio 28.11.2006)

Gjør kolesterollegemidler noe godt? (businessweek.com 17.1.2008)

Legemiddel mot kolesterol knyttet til søvnforstyrrelser (drugs.com 7.11.2007)

According to researchers at the University of Toronto, eating a certain 'portfolio' of foods including fish, oatmeal, almonds and lean meats can help reduce artery-clogging LDL cholesterol as much as statin drugs. The study, published on Wednesday in the American Journal of Clinical Nutrition, followed 55 overweight middle-aged men and women for a year. (netdoctor.co.uk 9.3.2006)

Legemidler mot høyt kolesterol kan forårsake Parkinsons sykdom (Cholesterol Drugs May Cause Parkinson's - Report) (newsmax.com 22.1.2007)

- For lavt kolesterol kan føre til kreft (vg.no 25.7.2007)

Crestor minskar inte risken att dö (lakemedelsvarlden.se 6.11.2007)

- Å selge sykdom

Å selge sykdom
Fra redaktøren
Tidsskr Nor Legeforen 2014; 134:1015 (27.5.2014)
At så godt som alle kliniske studier er kommersielt finansiert, er et stort problem i medisinen. Vi kan ikke i tillegg stoppe forsøk på å etterprøve resultatene

I oktober 2013 publiserte Abramson og medarbeidere en studie i BMJ som viste at statiner gitt til personer med lav risiko for kardiovaskulær sykdom verken reduserte totaldødelighet eller risiko for alvorlig sykdom, mens de fant om lag 18 % risiko for bivirkninger (1). På dette grunnlaget mente de at det ville være feil å utvide indikasjonsområdet for statiner, slik en Cochrane-rapport nylig hadde anbefalt (2). I etterkant av publiseringen var det en faglig diskusjon særlig rundt beregninger av bivirkningsfrekvensen, noe som førte til at forfatterne korrigerte tallet. Hovedfunnet – ingen effekt på totaldødelighet, og dermed mer risiko enn effekt – ble stående.

Så langt var alt som normalt: En artikkel kom inn til et tidsskrift, den ble kvalitetssikret redaksjonelt og av eksterne fagvurderere, publisert, kommentert og debattert i full åpenhet. Men dette er ikke hele historien: I desember 2013 oppsøkte Rory Collins, professor i medisin og epidemiologi ved universitetet i Oxford, sjefredaktør Fiona Godlee i BMJ og forlangte at artikkelen skulle trekkes tilbake. Da dette ikke førte frem, gikk han til britiske medier der han anklaget BMJ for å drive med en skrekkpropaganda som ville ta livet av svært mange mennesker (3). Da heller ikke dette førte frem, sendte han et konfidensielt brev til Godlee. Han avslo gjentatte ganger å delta i den faglige debatten på vanlig vis, nemlig åpent i BMJs spalter (4). (...)

(Anm: Reduksjon av hjertedød skyldes ikke statiner. Tidsskr Nor Legeforen 2016; 136:895 (7.6.2016).)

- Er eg sjuk? / Original episodetittel: Sygdom søges. / Episode 1 av 3 Dansk serie fra 2017.

(Anm: Er eg sjuk? Episode 1 av 3 Dansk serie fra 2017. Som et eksperiment får 100 mennesker tilbud om å teste seg for å få vite om de risikerer å bli alvorlig syke i framtiden. Hvor langt tør de gå når det går opp for dem hva prisen er? Produksjonsår: 2017 Original episodetittel: Sygdom søges. (nrk.no 30.8.2017).)

(Anm: Sygdom Søges, afsnit 1 - Video Dailymotion. (dailymotion.com/video)

(Anm: Sygdom Søges, afsnit 2 - Video Dailymotion. (dailymotion.com/video)

(Anm: Legemiddeløkonomi, bivirkninger og legemiddelomsetning (mintankesmie.no).)

(Anm: Styrelsesdirektør: Tal viser, at patientsikkerhed betaler sig. (- Det er der nu sat et beløb på. Og det er enorme summer. 15 procent af udgifterne i sundhedsvæsenet i nogle af verdens mest udviklede lande går til at rydde op efter brud på patientsikkerheden. Det konkluderer OECD i en ny rapport. (altinget.dk 2.6.2017).)

- Alvorlig bias (skjevhet) i 20 års oppfølgingsstudie av statinforsøk.

(Anm: Alvorlig bias (skjevehet) i 20 års oppfølgingsstudie av statinforsøk. BMJs nyhetsoppslag om oppfølgingsstudien av WOSCOPS-studien sier at total- og kardiovaskulær dødelighet ble betydelig redusert hos menn som ble plassert i behandlingsgruppen for 20 års oppfølging; spesielt blant de med de høyeste konsentrasjonene av LDL-kolesterol (LDL). (Serious bias in 20 year follow-up study of statin trial. BMJ’s news story on the follow-up study of the WOSCOPS trial says that total and cardiovascular mortality were considerably reduced in men allocated to the treatment group at 20 year follow-up; in particular among those with the highest concentrations of low density lipoprotein (LDL) cholesterol. 12 But the study has serious bias. As mentioned in the supplement: “At five years after the completion of the randomised trial 38.7% and 35.2% of patients originally allocated to pravastatin and placebo arms, respectively, were taking statins (P<0.001). No later data on the proportion of individuals on statins were available.” Many patients stop taking statins. In a study of over 140 000 elderly people, two thirds of those with cardiovascular disease (and even more of those without) had stopped treatment after two years.3 The question is, therefore, whether the mortality benefit among those with the highest LDL cholesterol is due to statin treatment or to their high LDL cholesterol.BMJ 2017;359:j4906 (Published 31 October 2017).)

(Anm: Bias [baies] -en, - skjevhet i vitenskapelig undersøkelse el. resultat pga. mangelfull systematikk i innsamlingen av data. Etym.: eng., fr. biais helning, tendens. Kilde: ordnett.no.)

(Anm: Bias; (...) valg og vurderinger som på systematisk måte avviker fra det som er faktisk korrekt. Kilde: Store norske leksikon.)

(Anm: Legemiddeletterlevelse (Tas legemidler som foreskrevet?) (Adherence to Medication.) (…) Legemidler virker ikke på pasienter som ikke tar dem. (Drugs don't work in patients who don't take them.)  (NEJM 2005;353:487-497(August 4).)

- Overdreven rapportering om nytteverdi i en mangelfull langvarig statinbehandlingsstudie. (- Nyhetsartikkelen og publikasjonen rapporterer at pravastatin i denne primære forebyggelsesundersøkelsen reduserte dødsfall fra hjertesykdom med 28 % hos menn med høye nivåer av LDL-kolesterol. Men 28 % er den relative risikoreduksjonen; det mer klinisk relevante målet for legemiddeleffektivitet er absolutt risikoreduksjon, som bare var 2,3 % mellom behandlede og ubehandlede grupper.) (- For å gjøre saken verre er de rapporterte nyttige effektene av langvarig statinbruk ikke bare liten, men også upålitelig. Etter avsluttet femårsforsøk stoppet flertallet av personer i behandlingsgruppen med statin, og en tredjedel av personer i placebogruppen hadde startet statinbehandling. Videre overvåket forskerne ikke hvilke deltakere som var på statin i løpet av de 15 årene med oppfølging. Det eneste vi kan være sikker på er at flertallet av mennesker i begge gruppene ikke var på statin i 15 års oppfølgingsperiode.)

(Anm: Exaggerated report of benefits in a flawed long term statin treatment study. The BMJ reports on the findings of a study on long term (20 year) treatment with a statin in the WOSCOPS trial by Vallejo-Vaz et al.12 The news article and publication report that, in this primary prevention trial, pravastatin reduced deaths from heart disease by 28% in men with high levels of LDL cholesterol. But 28% is the relative risk reduction; the more clinically relevant measure of drug effectiveness is absolute risk reduction, which was only 2.3% between treated and untreated groups. Both the study and the news story follow a pattern of focusing on the more dramatic, but misleading, relative risk statistic in statin trials.3 To make matters worse, the reported beneficial effects of long term statin use are not only minuscule but also unreliable. After the five year trial finished, the majority of people in the treatment group stopped taking their statin, and one third of the people in the placebo group had started statin treatment. Furthermore, the investigators did not monitor which participants were on a statin over the 15 years of follow-up. The only thing we can be certain of is that the majority of people in both groups were not on a statin in the 15 year follow-up period. We can’t be confident that the purported benefits of long term statin treatment reported by Vallejo-Vaz et al are valid. Despite the sensational headlines of The BMJ’s news story and the media attention this follow-up study generated, the study was so flawed in its methodology that it provided nothing of value in terms of guidance for clinicians seeking high calibre research on the long term effects of statins on coronary outcomes. BMJ 2017;359:j4915 (Published 31 October 2017).)

(Anm: Interessekonflikter, bestikkelser og korrupsjon (mintankesmie.no).)

(Anm: Gratis lunch, legemidler, grådighetskultur og korrupsjon (mintankesmie.no).)

- Leger som mottar de største utbetalingene fra legemiddelfirmaer deklarerer dem ikke på nytt nettsted.

(Anm: Leger som mottar de største utbetalingene fra legemiddelfirmaer deklarerer dem ikke på nytt nettsted. (Doctors getting biggest payments from drug companies don’t declare them on new website. BMJ 2016;354:i3679 (Published 01 July 2016).)

(Anm: Habilitet (integritet) (mintankesmie.no).)

(Anm: Legemiddelkonsulenter (sales representatives) (mintankesmie.no).)

(Anm: Legemiddelkonsulenter forteller leger lite om sideeffekter, ifølge studie. (Drug Reps Tell Docs Little of Side Effects: Survey) (Journal of General Internal Medicine 2013 (April).)

- Eldre voksne har kanskje ikke nytte av å ta statiner for å forhindre hjertesykdom.

(Anm: Eldre voksne har kanskje ikke nytte av å ta statiner for å forhindre hjertesykdom. Older adults may not benefit from taking statins to prevent heart disease. (…) Benjamin H. Han, an assistant professor in the Department of Medicine at New York University School of Medicine, NY, and colleagues report their findings in the journal JAMA Internal Medicine. Statins are a class of drugs that are used to lower blood levels of cholesterol, most of which is made in the liver. (medicalnewstoday.com 22.5.2017).)

(Anm: Interessekonflikter mht. retningslinjer / veiledere for behandling av seminal hepatitt C-virus og høyt kolesterol. (Conflict of Interest in Seminal Hepatitis C Virus and Cholesterol Management Guidelines. (…) Conclusions and Relevance. Neither the cholesterol guideline nor the hepatitis C virus guideline fully met the IOM standards for commercial COI management, and discordance between committee leader guideline disclosures and those in contemporaneous articles was common. Adherence to additional IOM standards for guideline development and evidence review was mixed. Adoption of consistent COI frameworks across specialty societies may help ensure that clinical guidelines are developed in a transparent and trustworthy manner.) JAMA Intern Med. 2017 (Published online January 17).)

- "Godt" kolesterol ikke så bra til å forebygge hjertesykdom. Det er en utbredt oppfatning at vi skal holde nivået på det "dårlige" kolesterolet i sjakk, mens "godt" kolesterol skal være høyt for å beskytte mot hjertesykdom og andre kardiovaskulære forhold.

(Anm: 'Good' cholesterol not so good at preventing heart disease. It is a widely held belief that we should keep levels of the "bad" cholesterol in check, while "good" cholesterol should be high in order to protect against heart disease and other cardiovascular conditions. But new research challenges this belief. (…) One such therapeutic strategy has been to block the activity of a protein called cholesterol ester transfer protein (CETP). But now a new study, published in the journal JAMA Cardiology, shows that raising levels of the so-called good cholesterol by blocking this protein does not do much to protect against heart disease. (medicalnewstoday.com 17.11.2017).)

(Anm: Uavhengig panel konkluderer at to studier publisert i BMJ på sideeffekter for statiner ikke bør trekkes tilbake (Two papers in The BMJ with statin side effect errors shouldn’t be retracted, independent panel concludes) BMJ 2014;349:g4993 (Published 04 August 2014).)

- Men vet vi egentlig nok om alle pillene vi putter i oss? (- De fleste forskningsstudier er bekostet av legemiddelindustrien selv. Det betyr at de i stor grad kan diktere den informasjonen og de resultatene de ønsker publisert, påpeker Geelmuyden.)

(Anm: Kolesterol: Kolesterolsenkende er blitt folkemedisin. Rundt 40 prosent av alle nordmenn over 65 år tar kolesterolsenkende medisiner. Men vet vi egentlig nok om alle pillene vi putter i oss? (…) Ifølge Steinar Madsen, medisinsk fagdirektør ved Statens legemiddelverk, var det i 2016 omlag 540 000 nordmenn som gikk på statiner. Det vil si drøyt ti prosent av den samlede befolkningen. (…) - De fleste forskningsstudier er bekostet av legemiddelindustrien selv. Det betyr at de i stor grad kan diktere den informasjonen og de resultatene de ønsker publisert, påpeker Geelmuyden. Konklusjonene i studiene spriker veldig: Fra «helt ufarlig, forebyggende medisin» til et medikament som for mange gir betydelige bivirkninger, og som bare én av 50 brukere virkelig har nytte av. Det siste kom frem i en metastudie som nylig ble publisert på nature.com. (…) I en undersøkelse der 22 profesjonelle idrettsutøvere med arvelig forhøyet kolesterol gikk på statiner, avsluttet 16 av dem - det vil si 75 prosent - behandlingen på grunn av muskelplager. (…) 1200 italienere med hjerteproblemer ble fulgt over sju år. Den viste at de som fulgte en foreskrevet middelhavsdiett bedret overlevelsen med 37 prosent. Hos statinbrukere ble den anslått til 18 prosent. Forskerne gir følgende gode - og enkle - råd: (…) (kk.no 14.11.2017).)

(Anm: Breakthrough discovery could change the way of treating cholesterol. (…) This accidental discovery, made by medical biochemist Henry Pownall, Ph.D., and his team at the Houston Methodist Research Institute, reveals a new pathway in the cholesterol-elimination chain that will be key to developing new drugs to lower cholesterol. Their findings are described in an article titled "ABCA1-Derived Nascent High Density Lipoprotein-Apo AI and Lipids Metabolically Segregate," appearing online Oct. 26 and in print Nov. 21 in the American Heart Association's Arteriosclerosis, Thrombosis, and Vascular Biology journal. Pownall, who is the corresponding author, said the initial purpose of their study was to prove the current model of cholesterol transport through the body was correct. It turns out, however, that the model was not quite right. (news-medical.net.com 28.10.2017).)

(Anm: Open letter raises concerns about NICE guidance on statins. BMJ 2014;348:g3937 (Published 11 June 2014) .)

(Anm: Statin initiation is unrelated to cardiovascular risk score, finds study. General practices in England and Wales start patients on statins seemingly haphazardly, often without documented evidence that their cardiovascular risks have been properly assessed, a study of 248 practices has shown. GPs are recommended by the UK National Institute for Health and Care Excellence (NICE) to use the QRISK2 score to help decide whether patients should be started on statins. But only around a quarter of patients who began taking the drugs after 2012, when this recommendation was made, have a QRISK2 score documented in their patient record. And of those who do have a score recorded, only 35% of those with a high score were actually started on statins, found Samuel Finnikin and colleagues from the University of Birmingham in a paper published in the British Journal of General Practice.1 BMJ 2017;359:j4898 (Published 24 October 2017).)

- Tette arterier kan skyldes bakterier, ikke diett. Fettmolekylene i plakk som tetter våre arterier og øker risikoen for hjerteinfarkt og hjerneslag, kan komme fra bakterier som lever i vår munn og tarm, ikke bare fra det vi spiser.

(Anm: Tette arterier kan skyldes bakterier, ikke diett. Fettmolekylene i plakk som tetter våre arterier og øker risikoen for hjerteinfarkt og hjerneslag, kan komme fra bakterier som lever i vår munn og tarm, ikke bare fra det vi spiser. Dette var hovedresultatet i en studie ledet av University of Connecticut i Storrs som nylig ble publisert i Journal of Lipid Research. (Clogged arteries may be down to bacteria, not diet. The fat molecules in the plaques that clog up our arteries and raise risk of heart attack and stroke may come from bacteria that live in our mouths and guts, not just from what we eat. This was the main result of a study led by the University of Connecticut in Storrs that was published recently in the Journal of Lipid Research. (medicalnewstoday.com 3.11.2017).)

(Anm: [Medicin]  - Ateromer dannet af aflejring af fedt og kolesterol kan føre til åreforkalkning (Atheromas formed by deposits of fat and colesterol may lead to arteriosclerosis) (ordbogen.com).)

(Anm: Gut bacteria may impact body weight, fat and good cholesterol levels (medicalnewstoday.com 11.9.2015).)

(Anm: Antibiotika (tarmbakterier, probiotika, mikrobiota etc.) (Dysbiose; dysbiosis (also called dysbacteriosis (dysbakteriose)). (mintankesmie.no).)

(Anm: Pancreatic cancer risk linked to changes in mouth bacteria. The presence of certain bacteria in the mouth may indicate a raised risk for pancreatic cancer - a disease that often begins with no symptoms and for which there is no routine screening test. (…) The researchers suggest the finding may lead to earlier, more precise treatments for pancreatic cancer, a disease with a pitifully low survival rate as it often escapes early diagnosis. (medicalnewstoday.com 20.4.2016).)

(Anm: A journey into the brain: insight into how bacterial pathogens cross blood–brain barriers. The blood–brain barrier, which is one of the tightest barriers in the body, protects the brain from insults, such as infections. Indeed, only a few of the numerous blood-borne bacteria can cross the blood–brain barrier to cause meningitis. In this Review, we focus on invasive extracellular pathogens, such as Neisseria meningitidis, Streptococcus pneumoniae, group B Streptococcus and Escherichia coli, to review the obstacles that bacteria have to overcome in order to invade the meninges from the bloodstream, and the specific skills they have developed to bypass the blood–brain barrier. The medical importance of understanding how these barriers can be circumvented is underlined by the fact that we need to improve drug delivery into the brain. Nature Reviews Microbiology 2017 (Published online 16 January 2017).)

(Anm: NICE should publish numbers needed to treat and harm for statins. BMJ 2014;348:g3458 (Published 11 June 2014).)

(Anm: Concerns about the latest NICE draft guidance on statins BMJ 2014;349:g4130 (09 July 2014).)

(Anm: Kan statiner senke risikoen for Alzheimer? En ny studie antyder at de kolesterolsenkende medisinene kan gi folk litt lavere risiko for å få Alzheimer. Men statinene virker ikke for alle. (…) I 2016 kom en Cochrane-oppsummering – slike studier anses som svært grundige – som konkluderte med at statiner etter all sannsynlighet ikke beskytter mot demens. Nå publiseres imidlertid en ny undersøkelse som utdyper saken en smule. Den viser at ulike statiner gir forskjellig effekt på mennesker fra ulike grupper. (forskning.no 18.12.2016).)

(Anm: Statiner: Ingen nytte som primær sykdomsforebygging hos eldre. Statins: No benefit as primary prevention in elderly. (…) (Anm: Statiner: Ingen nytte som primær sykdomsforebygging hos eldre. Statins: No benefit as primary prevention in elderly. (mdedge.com 24.5.2017).)

- Statiner øger risiko for sukkersyge. Kolesterol-sænkende lægemidler med statin kan øge risikoen for type-2 diabetes.

(Anm: Statiner øger risiko for sukkersyge. Kolesterol-sænkende lægemidler med statin kan øge risikoen for type-2 diabetes. Det skriver det selvstændige franske magasin Prescrire, der har lavet et review af 13 studier med statin til ikke-diabetiske patienter. I alt indgik 91.000 patienter i undersøgelsen, og var i gennemsnit monitoreret i fire år. Af de 91.000 fik 4.278 diabetes, heraf 2.226 var i statin-behandling mod 2.052 i kontrolgruppen. Det svarer til, at én patient for hver 255, der tager statin, får diabetes. Prescrire henviser til, at andre større studier har vist det samme, men mener ikke, at statiner ikke skal bruges forebyggende. Les mere her. (pharmadanmark.dk 27.1.2017).)

(Anm: Statins increase the risk of developing diabetes in at-risk people. Among susceptible individuals, statins — which are a common cholesterol-lowering medication — could increase the risk of type 2 diabetes by 30 percent. These new findings are sure to reignite debate. (medicalnewstoday.com 24.10.2017).)

(Anm: Type 2 diabetes can be reversed with intensive medical treatment using oral medications, insulin and lifestyle therapies, according to a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. (news-medical.net .com 15.3.2017).)

(Anm: Statins increase the risk of developing diabetes in at-risk people. (medicalnewstoday.com 24.10.2017).)

- Type-2 diabetes og statiner. En ny studie antyder at bruk av statiner kan øke langtidsblodsukkeret med så mye som ett prosentpoeng.

(Anm: Type-2 diabetes og statiner. En ny studie antyder at bruk av statiner kan øke langtidsblodsukkeret med så mye som ett prosentpoeng. En annen studie fra januar 2012, viser at bruk av statiner kan øke risikoen for å få type 2-diabetes. Ifølge en studie som ble forhåndspublisert på nett i tidsskriftet Atherosclerosis i mai 2012, har bruk av de kolesterolsenkende medikamentene statiner, innvirkning på langtidsblodsukkeret (HbA1c) hos personer med type 2-diabetes. Forfatterne bak studien undersøkte langtidseffekten av statinene rosuvastatin og simvastatin på insulinsensitivitet og utskillelse hos personer med godt kontrollert type 2-diabetes. (nhi.no 21.6.2017).)

(Anm: Cholesterol-lowering statins linked to increased risk of diabetes in older women. Older Australian women taking cholesterol-lowering statins face a significantly increased risk of developing diabetes, according to a University of Queensland study. - Type-2 diabetes og statiner. En ny studie antyder at bruk av statiner kan øke langtidsblodsukkeret med så mye som ett prosentpoeng.

(Anm: Type-2 diabetes og statiner. En ny studie antyder at bruk av statiner kan øke langtidsblodsukkeret med så mye som ett prosentpoeng. En annen studie fra januar 2012, viser at bruk av statiner kan øke risikoen for å få type 2-diabetes. Ifølge en studie som ble forhåndspublisert på nett i tidsskriftet Atherosclerosis i mai 2012, har bruk av de kolesterolsenkende medikamentene statiner, innvirkning på langtidsblodsukkeret (HbA1c) hos personer med type 2-diabetes. Forfatterne bak studien undersøkte langtidseffekten av statinene rosuvastatin og simvastatin på insulinsensitivitet og utskillelse hos personer med godt kontrollert type 2-diabetes. (nhi.no 21.6.2017).)

UQ School of Public Health researcher Dr Mark Jones said women over 75 faced a 33 per cent higher chance of developing diabetes if they were taking statins. The risk increased to over 50 per cent for women taking higher doses of statins. (news-medical.net 15.3.2017).)

- Statiner knyttet til høyere risiko for diabetes hos eldre kvinner.

(Anm: Statiner knyttet til høyere risiko for diabetes hos eldre kvinner. Statins linked to higher risk of diabetes in older women. Statins are often prescribed for older women with high levels of blood cholesterol, yet the effects of the drug have not been as well-studied in this group as in others. Now, a new study from Australia finds that older women taking statins to lower cholesterol may have a significantly higher risk of developing diabetes. The research - by a team at the University of Queensland (UQ) in Brisbane, Australia - is published in the journal Drugs & Aging. The study finds that among a group of more than 8,000 women aged 75 and over, those taking statins had a 33 percent higher chance of being diagnosed with new-onset diabetes. (medicalnewstoday.com 16.3.2017).)

(Anm: - Den observerte sammenhengen mellom bruk av sovepiller og forhøyet LDL kolesterol er spesielt bekymringsfullt gitt den dramatiske økningen i bruken av beroligende legemidler i den generelle befolkningen i de senere år. ("The observed link between sleeping pill use and elevated LDL cholesterol is particularly concerning given the dramatic rise in the use of sedative medicine in the general population in recent years," he said.) (medicalnewstoday.com 1.3.2016).)

(Anm: Mange kvinder får kolesterolsænkende medicin uden grund. Flere end halvdelen af de midaldrende kvinder, som får kolesterolsænkende medicin af typen 'statiner', har hverken hjertekarsygdom eller sukkersyge, viser et dansk studie. Det bekymrer en dansk forsker. (videnskab.dk 3.3.2016).)

(Anm: Cathrine Christiansen, pensjonert biokjemiker. Vibeke Telle-Hansen og medarbeidere påpeker på nytt, i Aftenposten 25. januar, at høyt LDL-kolesterol gir økt risiko for hjerte- og karsykdommer og trekker frem at personer med familiær hyperkolesterolemi dør nesten 20 år tidligere enn resten av befolkningen. Det er riktig at disse personene har økt risiko for tidlig død, men dette gjelder kun for aldersgruppen 20–39 år. Årsaken er en genmutasjon som gjør at enkelte lettere danner blodpropper som kan forårsake tette årer. (…) At høyt LDL-kolesterol ikke gir økt risiko for tidlig død i den eldre del av befolkningen, kommer godt frem av en artikkel i British Medical Journal i fjor. Der ble det vist til 19 studier med nesten 69.000 deltagere hvor man hadde studert sammenhengen mellom nivå av LDL-kolesterol og dødelighet for personer over 60 år. Ingen av studiene viste at høyt LDL-kolesterol var assosiert med økt dødelighet. Tvert imot. For 92 % av deltagerne var det de med høyest LDL-kolesterolnivå som levde lengst. (1134). (aftenposten.no 30.1.2017).)

- Bruk av statiner kan øke risiko for katarakt.

(Anm: Statin use may raise cataract risk. New research suggests that use of statins, a class of drugs taken by millions of Americans with high cholesterol, is linked to a higher risk for developing cataracts. Dr. Jessica Leuschen, of the San Antonio Military Medical Center, Texas, and colleagues report their findings in a paper published online in JAMA Ophthalmology. According to the US Centers for Disease Control and Prevention (CDC), cataracts, a predominantly age-related condition where the lens of the eye becomes cloudy, is the leading cause of vision loss in the US. (medicalnewstoday.com 24.9.2013).)

- Statiner linket til katarakt

Statins Linked to Cataracts (Statiner linket til katarakt)
medpagetoday.com 19.9.2013
Statiner fjerner kolesterol fra blod, men de gjør det på bekostning av synet antyder en ny "score-matched study". (Statins clear cholesterol from the blood but they may do so at the risk of obstructing vision, a new propensity score-matched study suggested.)

In the primary analysis of 6,972 matched pairs of statin users and nonusers, those taking the cholesterol-lowering medication had a 9% increased risk of developing cataracts (95% CI 1.02-1.17), reported Ishak Mansi, MD, of the VA North Texas Health System at the University of Texas Southwestern in Dallas, and colleagues.

In a secondary subgroup analysis of 33,513 patients (6,113 on statins) who had no comorbidity, based on the Charlson comorbidity index, the use of statins remained significantly associated with cataracts (OR 1.27, 95% CI 1.15-1.40), according to the study published online in JAMA Ophthalmology. (...)

(Anm: Øyesykdommer (øyner er sjelens vindu). (mintankesmie.no).)

(Anm: Antidepressiva (øyesykdommer). (mintankesmie.no).)

(Anm: Association of Statin Use With Cataracts: A Propensity Score–Matched Analysis. JAMA Ophthalmol. 2013 (September 19, 2013).)

- Statiner kan fremme Parkinsons sykdom (PD): Insikt i en stor nasjonal database for erstatningskrav.

Statins may facilitate Parkinson's disease: Insight gained from a large, national claims database.
Mov Disord. 2017 Apr 3. doi: 10.1002/mds.27006. [Epub ahead of print]
Abstract
OBJECTIVE: Using a large U.S. claims database (MarketScan), we investigated the controversy surrounding the role of statins in Parkinson's disease (PD).

METHODS: We performed a retrospective case-control analysis. First, we identified 2322 incident PD cases having a minimum of 2.5 years of continuous enrollment prior to earliest diagnosis code or prescription of antiparkinson medication. A total of 2322 controls were then matched individually by age, gender, and a follow-up window to explore the relationship of statin use with incident PD.

RESULTS: Statin usage was significantly associated with PD risk, with the strongest associations being for lipophilic (odds ratio = 1.58, P < .0001) versus hydrophilic (odds ratio = 1.19, P = .25) statins, statins plus nonstatins (odds ratio = 1.95, P < .0001), and for the initial period after starting statins (<1 year odds ratio = 1.82, 1-2.5 years odds ratio = 1.75, and ≥2.5 years odds ratio = 1.37; Ptrend < .0001).

CONCLUSION: The use of statin (especially lipophilics) was associated with higher risk of PD, and the stronger association in initial use suggests a facilitating effect. © 2017 International Parkinson and Movement Disorder Society. (...)

(Anm: Cholesterol Drugs May Cause Parkinson's - Report (Legemidler mot høyt kolesterol kan forårsake Parkinsons sykdom. (newsmax.com 22.1.2007).)

(Anm: Statin use may speed up onset of Parkinson's disease symptoms, study suggests. (…) After analyzing the data, researchers found that prior statin use was associated with higher risk of Parkinson's disease and was more noticeable during the start of the drug use. (news-medical.net 14.6.2017).)

(Anm: Low LDL cholesterol, PCSK9 and HMGCR genetic variation, and risk of Alzheimer’s disease and Parkinson’s disease: Mendelian randomisation study. (…) Conclusion Low LDL cholesterol levels due to PCSK9 and HMGCR variants had no causal effect on high risk of Alzheimer’s disease, vascular dementia, any dementia, or Parkinson’s disease; however, low LDL cholesterol levels may have a causal effect in reducing the risk of Alzheimer’s disease. BMJ 2017;357:j1648 (Published 24 April 2017).)

- Statiner bør kanskje ikke brukes til beskyttelse mot Parkinsons sykdom. (- Forskningsdata publisert i tidsskriftet Movement Disorders indikerer at statiner kan øke disposisjonen for Parkinsons sykdom hos enkelte pasienter.)

(Anm: Statiner bør kanskje ikke brukes til beskyttelse mot Parkinsons sykdom. Statins may not be used for protection against Parkinson's disease. Research data published in the journal Movement Disorders indicate that statins can increase susceptibility to Parkinson's disease in certain patients, ScienceDaily reported Wednesday. (…)  The research team found that prior statin use was linked to an elevated risk of Parkinson's disease, with the risk being most noticeable during the start of treatment. (firstwordpharma.com 14.6.2017).)

(Anm: Statins may raise the risk of Parkinson's disease. (…) Recently, there has been an increasing interest in the potential of statins to protect brain cells and thus prevent the onset of neurodegenerative diseases such as Parkinson's and Alzheimer's disease. But the evidence in support of this neuroprotective role has been inconsistent or has depended on animal models and cell cultures.  (medicalnewstoday.com 15.6.2017).)

Low cholesterol linked to Parkinson's risk in men
NEW YORK (Reuters Health) 29.9.2005
- Is it possible to have too low a level of cholesterol? A cholesterol profile that reduces the risk of heart disease may increase the risk for Parkinson's disease -- at least for men -- researchers report.

Going back several years, studies have uncovered associations between low cholesterol and suicide, stroke, depression, even violence. While the findings in most cases did not stand up to scrutiny, the suspicion remains that very low cholesterol might influence mental function.

Now, at the annual meeting the American Neurological Association held this week in San Diego, California, Dr. Xuemei Huang described a possible link to Parkinson's disease.

Huang and colleagues, from the University of North Carolina at Chapel Hill, measured the lipid levels of 124 Parkinson's patients and a group of 112 similar people free of Parkinson's disease. (...)

(Anm: Reduksjon av hjertedød skyldes ikke statiner. Tidsskr Nor Legeforen 2016; 136:895 (15.6.2016).)

(Anm: Statin prescribing according to gender, age and indication: what about the benefit-risk balance? J Eval Clin Pract. 2015 Oct 8. doi: 10.1111/jep.12462. [Epub ahead of print].)

- Postmenopausale kvinder overmedicineres med statiner. Mange danske kvinder får efter overgangsalderen ordineret statiner, uden at der nødvendigvis er faglig basis for det.

(Anm: Postmenopausale kvinder overmedicineres med statiner. Mange danske kvinder får efter overgangsalderen ordineret statiner, uden at der nødvendigvis er faglig basis for det. Det konkluderer et nyere dansk studie, der har undersøgt data fra over fire mio. danskere over ti år. Kvinder over 50 år får i stigende omfang ordineret de kolesterolsænkende statiner, hvilket kan give unødvendige ulemper for kvinderne. Det sker nemlig ofte som følge af det naturligt forhøjede kolesteroltal, der følger med overgangsalderen, og som ikke nødvendigvis er skadeligt. Det er konklusionen på et dansk studie, som for nylig blev publiceret i Journal of […] (dagenspharma.dk 14.3.2016).)

(Anm: Statinstopp kopplas till mediernas rapportering. Att exponeras för negativa nyheter om statiner verkar kunna få patienter att sluta använda läkemedlet, enligt en ny studie i tidskriften European Heart Journal. (…) Det omvända sågs när det gällde positiva nyheter. Då tenderade fler till att hämta statiner efter ett halvår. (dagensmedicin.se 24.3.2016).)

(Anm: Negative statin-related news stories decrease statin persistence and increase myocardial infarction and cardiovascular mortality: a nationwide prospective cohort study.Eur Heart J. 2016 Mar 14;37(11):908-16. doi: 10.1093/eurheartj/ehv641. Epub 2015 Dec 1.)

(Anm: Advarer mot statinslutt etter mediaoppslag. Mens Serena Tonstad er bekymret for virkningene av negative nyhetsoppslag og og at pasienter på egenhånd slutter med statiner, mener Gisle Roksund de snarere kan forhindre overbehandling. (dagensmedisin.no 24.3.2016).)

(Anm: New cholesterol methods needed in wake of failed drugs, heart researchers say (finance.yahoo.com 3.4.2016).)

- Even the latest, most potent cholesterol-lowering drugs, PCSK9 inhibitors, let alone widely used statins, cannot fully reverse damage done to arteries over time, and so they can't prevent roughly 500,000 heart attacks per year in the United States," says lead study author Edward Fisher, MD, PhD, director of the Marc and Ruti Bell Vascular Biology and Disease Program at NYU Langone.

(Anm: Mechanism shown to reverse disease in arteries. A certain immune reaction is the key, not to slowing atherosclerosis like cholesterol-lowering drugs do, but instead to reversing a disease that gradually blocks arteries to cause heart attacks and strokes. This is the finding of a study in mice led by researchers at NYU Langone Medical Center and published online in the Journal of Clinical Investigation. (…) "Even the latest, most potent cholesterol-lowering drugs, PCSK9 inhibitors, let alone widely used statins, cannot fully reverse damage done to arteries over time, and so they can't prevent roughly 500,000 heart attacks per year in the United States," says lead study author Edward Fisher, MD, PhD, director of the Marc and Ruti Bell Vascular Biology and Disease Program at NYU Langone. (medicalnewstoday.com 28.6.2017).)

(Anm: It looked like a surefire way to make billions. (…) Analysts estimated sales at more than $3 billion a year. But the two drugs have been commercial flops1, in part due to a complicated reimbursement system that has frustrated doctors, confused patients, and left the biotech industry worried about the implications for other high-priced drugs in the pipeline. (…) No one disputes that the new drugs, Repatha and Praluent, are excellent at lowering bad cholesterol, or LDL. (statnews.com 28.10.2016).)

(Anm: De orimliga kraven driver utvecklingen framåt. Statinbehandling av friska eller förlossningsvård de luxe – genom att tänja på gränserna kan vi flytta dem framåt, menar chefredaktör Ingrid Helander. (lakemedelsvarlden.se 7.4.2016).)

(Anm: Editorials. Statins, news, and nuance. BMJ 2016;353:i3379 Journalism that exposes the public to ongoing controversies in science should be nurtured. (…) Matthews and colleagues projected excess cardiovascular events as a result of discontinued statin use.1 They did not explore the possibility of reduced reports of muscle pain, rhabdomyolysis, liver damage, diabetes, or cognitive side effects. (Published 28 June 2016).)

(Anm: Editorials. Is this muscle pain caused by my statin? BMJ 2017;357:j3030 (Published 23 June 2017.)

- Myotoksisitet av statiner: Mekanisme. (- Forekomsten av statinindusert myotoksisitet (SIM) opptrer hos 7 til 29 % av pasientene, avhengig av innrapporteringer. (The incidence of statin-induced myotoxicity (SIM) is presented by 7 to 29% of patients, depending upon the report.))

Myotoxicity of statins: Mechanism of action.
Pharmacol Ther. 2017 Feb 13. pii: S0163-7258(17)30043-8. [Epub ahead of print]
Abstract Statins are effective drugs to reduce cardiovascular events secondary to dyslipidemia; however, they cause frequent undesirable side effects. The incidence of statin-induced myotoxicity (SIM) is presented by 7 to 29% of patients, depending upon the report. SIM may develop in presence of abnormally high concentrations of statins in the myocyte and/or in presence of muscular conditions that may predispose to SIM. High concentrations of statins in the myocyte may occur whenever the activity of liver influx membrane transporters, namely OATP1B1, of drug metabolizing enzymes, and of liver and muscular efflux transporters, MDR1 and BCRP, is reduced. In the muscle, conditions that may predispose to SIM include mitochondrial damage with disruption of the mitochondrial respiratory chain and decreased production of ATP, increase of ROS, and leak of cytochrome c and Ca2+. In the sarcoplasma, statins activate MAPK and diminish the RhoA/AKT/mTOR/PGC-1α pathway. All these effects contribute to activate apoptosis, proteolysis, and muscle remodeling. Moreover, in the sarcoplasma, statins can reduce the resting chloride channel conductance, as well as lactate efflux. These changes will be responsible of fatigue, cramps, myalgia and elevation of serum CK. To date, besides avoiding drug-drug interactions and alcohol consumption, and correcting hypothyroidism, two strategies could be useful to prevent/diminish SIM, e.g. gradual dose titration with statins less prone to produce SIM, and high supplements of vitamin D in subjects with low plasma concentrations of 25(OH) D3. (…)

(Anm: Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle. (…) While statin therapy lowers ASCVD risk, these HMG-CoA reductase inhibitors are also associated with a risk of myotoxicity (4), and their impact on skeletal muscle health in those with T1DM has not yet been fully examined. Front. Endocrinol. 2016 (19 July 2016).)

(Anm: Bruk av statiner og risiko for herpes zoster. (Statin use and the risk of herpes zoster: a nested case-control study using primary care data from the U.K. Clinical Research Practice Datalink. (…) CONCLUSIONS: These findings are consistent with the hypothesis that statin therapy leads to an increase in the risk of HZ.) Br J Dermatol. 2016 Dec;175(6):1183-1194. Epub 2016 Nov 2.)

(Anm: Helvetesild – herpes zoster. (…) Hva er helvetesild? Helvetesild også kalt herpes zoster, forårsakes av varicella zoster-viruset. Det er et herpes-virus, men ikke likt de som gir infeksjon på leppene og på kjønnsorganet. (helsebiblioteket.no.no 23.1.2017).)

(Anm: Myotoxic (comparative more myotoxic, superlative most myotoxic) 1. That induces rapid necrosis of muscle (en.wiktionary.org).)

(Anm: Myotoxicity associated with lipid-lowering drugs. Curr Opin Rheumatol. 2007 Jan;19(1):67-73.)

- Muskelsymptomer hos statin-brukere kan være en "Nocebo-effekt"

Muscle Symptoms in Statin Users Might Be a “Nocebo Effect”
NEJM 2017 (May 25)
Patients who knew they were taking statins were more likely to experience statin side effects.
Bruce Soloway, MD

In randomized, blinded clinical trials, statin therapy is associated only rarely with myopathy (muscle pain or weakness plus substantially elevated creatine kinase levels; generally <0.2% of patients per year of treatment). But, in observational studies, as many as one fifth of statin users report muscle pain or weakness.

To better understand this discrepancy, researchers (funded by a manufacturer of atorvastatin) reanalyzed data from the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA; NEJM JW Gen Med May 15 2003 and Lancet 2003; 361:1149), in which more than 10,000 adults with hypertension were randomized to daily atorvastatin (10 mg) or placebo. The lipid arm of the trial was stopped after a mean 3.3 years of follow-up after an interim analysis showed significantly better cardiovascular outcomes with atorvastatin. All patients then were offered open-label atorvastatin (about two thirds of each group accepted), and clinical follow-up continued for a mean 2.3 additional years.

In the blinded phase, muscle symptoms were reported at a similar rate in both groups (about 2% annually). However, in the unblinded phase, muscle symptoms were reported significantly more often among statin users than nonusers (1.26% vs. 1.00% annually).

Comment
In this study, selection and ascertainment bias were eliminated, because the same patients and ascertainment methodology were used in both phases. It appears to exemplify the “nocebo effect” — the subjective experience of expected adverse drug effects that occurs equally in both arms of a blinded trial but is revealed in an unblinded observational study. Editorialists urge physicians to “alert their patients to possible statin-associated side-effects without raising negative expectations.” (…)

(Anm: Myotoxicity associated with lipid-lowering drugs. Curr Opin Rheumatol. 2007 Jan;19(1):67-73.)

(Anm: Biverkningar av statiner tolkas som noceboeffekt. Blindade och oblindade studier gav olika resultat vad gällde biverkningar. Resultaten tyder på noceboeffekt. (dagensmedicin.se 4.5.2017).)

(Anm: Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial—Lipid-Lowering Arm (ASCOT-LLA): a randomised double-blind placebo-controlled trial and its non-randomised non-blind extension phase. (…) Results (…) We noted no significant differences between statin users and non-users in the rates of other AEs, with the exception of musculoskeletal and connective tissue disorders (992 [8·69% per annum] vs 831 [7·45% per annum]; 1·17 [1·06–1·29]; p=0·001) and blood and lymphatic system disorders (114 [0·88% per annum] vs 80 [0·64% per annum]; 1·40 [1·04–1·88]; p=0·03), which were reported more commonly by statin users than by non-users. Lancet 2017 (Published: 02 May 2017).)

(Anm: Bias [baies] -en, - skjevhet i vitenskapelig undersøkelse el. resultat pga. mangelfull systematikk i innsamlingen av data. Etym.: eng., fr. biais helning, tendens. Kilde: ordnett.no.)

(Anm: Bias; (...) valg og vurderinger som på systematisk måte avviker fra det som er faktisk korrekt. Kilde: Store norske leksikon.)

(Anm: Legemiddeletterlevelse (Tas legemidler som foreskrevet?) (Adherence to Medication.) (…) Legemidler virker ikke på pasienter som ikke tar dem. (Drugs don't work in patients who don't take them.)  (NEJM 2005;353:487-497(August 4).)

- Atorvastatin (ATV) som vanligvis brukes til å behandle dyslipidemi rapporteres også å ha effekt mot 6-hydroksydopamin (6-OHDA) indusert nevrotoksisitet. I tillegg kan atorvastatin forstyrre mitokondriell funksjon ved å redusere nivået av Q10. Derfor kan den terapeutiske effekten av atorvastatin (20 mg / kg) bli kompromittert. (- De aktuelle resultater gir bevis på at tilskudd av Q10 til ATV viser synergistisk effekt ved å redusere dopamin toksisitet.) (- Det var signifikant reduksjon i mitokondriell kompleks enzymaktivitet og mitokondrielt membranpotensial (MMP).)

(Anm: Abstract Atorvastatin (ATV) generally used to treat dyslipidemia is also reported to have effect against 6-hydroxydopamine (6-OHDA) induced neurotoxicity. Additionally, atorvastatin can interfere with mitochondrial function by reducing the level of Q10. Therefore, the therapeutic effect of atorvastatin (20 mg/kg) could be compromised. In this context, the present study evaluated the effect of ATV supplemented with Q10. 6-OHDA was unilaterally injected into the right striatum of male rats. On day 8 of 6-OHDA infusion, ATV (20 mg/kg), Q10 (200 mg/kg), and their combination were administered per oral for 14 days. On day 21, there was significant loss of striatal dopamine indicating neurotoxicity. The combination of ATV+Q10 showed significant amelioration of dopamine (DA) toxicity compared to individual treatments. Similarly, ATV+Q10 compared to individual treatment significantly decreased the motor deficits induced by 6-OHDA. Further, 6-OHDA induced mitochondrial dysfunction in the substantia nigra pars compacta (SNpc). There was significant decrease in mitochondrial complex enzyme activities and mitochondrial membrane potential (MMP). Treatment with ATV and ATV+Q10 ameliorated mitochondrial dysfunction by increasing complex enzyme activities; however, only ATV+Q10 were able to stabilize MMP and maintained mitochondrial integrity. Moreover, there was significant induction of oxidative stress as observed from increase in lipid peroxidases (LPO) and nitrite (NO), and decrease in super oxide dismutase (SOD). Treatment with ATV+Q10 significantly altered the above effects indicating antioxidant activity. Furthermore, only combination of ATV and Q10 decreased the 6-OHDA induced expression of cytochrome-C, caspase-9 and caspase-3. Therefore, current results provide evidence that supplementation of Q10 with ATV shows synergistic effect in reducing dopamine toxicity. Neurotox Res. 2017 May;31(4):478-492.)

(Anm: Legemiddelinduserte mitokondrielle skader og sykdom. (Medication-induced mitochondrial damage and disease.) (mintankesmie.no).)

- Kolesterolpiller udsætter kun døden nogle få dage

Kolesterolpiller udsætter kun døden nogle få dage
jyllands-posten.dk 4.10.2015
Den livsforlængende effekt ved medicin mod højt kolesteroltal er stærkt overvurderet, viser danske forskere.

Omkring 600.000 danskere spiser hver dag medicin mod for højt kolesterol i blodet.

Men ifølge opsigtsvækkende ny forskning fra Syddansk Universitet (SDU) er den livsforlængende effekt af medicinen beskeden.

I gennemsnit udskydes døden kun med få dage efter flere års behandling, viser resultaterne fra Forskningsenheden for Klinisk Farmakologi.

Her har forskere som de første i verden systematisk indsamlet data fra alle de kliniske forsøg, som belyser medicinens effekt på dødeligheden. (…)

- Pillerne er billige, de har sjældent alvorlige bivirkninger, og der er ikke tvivl om, at der er en gevinst i forhold til risikoen for at få en ny blodprop.

Til gengæld mener forskerne, at de nye resultater er relevante i forhold til bivirkninger.

- Man kan med fordel bruge vores resultater til de patienter, der har forfærdelige bivirkninger af medicinen i form af muskelsmerter eller muskelsvækkelse. Og som i dag får den besked af deres læge at holde ud, fordi det er livsvigtigt, at de tager medicinen.

- Her er det relevant, at de overvejer om daglige smerter og gener er det værd til gengæld for en livsforlængelse på nogle dage, siger Jesper Pallas. (…)

(Anm: The effect of statins on average survival in randomised trials, an analysis of end point postponement. BMJ Open 2015;5:e007118.)

(Anm: Statins: How safe are they? Despite evidence that aims to quash controversy over the safety and effectiveness of statins, uncertainty remains. Is the safety of statins as debatable as some stories suggest, or is the controversy behind this group of medicines potentially harming more people than the drug itself? We find out. (medicalnewstoday.com 12.5.2017).)

(Anm: Statinintoleranse. I 2015 fikk over 530 000 mennesker resept på statiner i Norge. Bivirkninger fra muskel-skjelett-systemet og mindre spesifikke bivirkninger rapporteres ofte. Omfanget står i kontrast til observasjoner gjort i randomiserte, kontrollerte studier, der forekomsten av slike bivirkninger rapporteres på linje med det man finner ved placebobehandling. Legemiddelpauser, lave doseringer, bytting av preparat og bruk av andre lipidsenkende preparater er de mest aktuelle fremgangsmåter for å håndtere bivirkninger. Tidsskr Nor Legeforen 2017; 137:36-8 (10.1.2017).)

(Anm: Statins for primary prevention. Many organisations support shared decision making. Otto discusses statins for prevention of cardiovascular disease in selected asymptomatic patients.1 She says that “all guidelines emphasise shared decision making, but none provides the tools needed for fully informed decisions.” BMJ 2017;356:j479 (Published 27 January 2017).)

(Anm: Statins Aren’t the Only Way to Lower Cholesterol. (…) In a new report published in JAMA, Dr. Marc Sabatine, a cardiologist at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, and his colleagues scanned 49 trials involving nine different ways to lower cholesterol in more than 300,000 people to find out. (time.com 27.9.2016).)

(Anm: 'No scientific evidence' for the use of statins, experts claim. The push for statins cannot be described as evidence based until the raw data surrounding its trials is made public, a group of leading experts have claimed. (…) The authors of the editorial in the Prescriber claims that 'gross exaggeration' of benefits and downplaying of side-effects has 'likely led to the overmedication of millions of people across the world'. It follows a meta-analysis in the Lancet that claimed that for every 10,000 people taking the equivalent of atorvastatin 40mg daily - lowering LDL cholesterol by about 2 mmol/L or 77 mg/dL-  for five years, 500 would be spared a first ever CV event. (pulsetoday.co.uk 25.11.2016).)

(Anm: Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle. (…) While statin therapy lowers ASCVD risk, these HMG-CoA reductase inhibitors are also associated with a risk of myotoxicity (4), and their impact on skeletal muscle health in those with T1DM has not yet been fully examined. Front. Endocrinol. 2016 (19 July 2016).)

(Anm: Risk of hemorrhage with statins and stroke prevention drug combination. Two commonly used statins can increase the risk of hemorrhage when combined with dabigatran etexilate, a drug often used for preventing stroke in patients with atrial fibrillation, according to a study in CMAJ (Canadian Medical Association Journal). (medicalnewstoday.com 22.11.2016).)

(Anm: CardioBrief: Statin Trialists Try to Bury Debate With Evidence. —But some disagree with review's claims of overwhelming evidence (medpagetoday.com 9.9.2016).)

(Anm: – Overdrevne påstander om statin-bivirkninger har skadet folks helse. Redaktøren av The Lancet, Richard Horton, peker på at kontroversene rundt påstander om bivirkninger knyttet til statinbehandling førte til at folk sluttet å ta dem. (dagensmedisin.no 20.9.2016).)

(Anm: CardioBrief: Statin Trialists Try to Bury Debate With Evidence. But some disagree with review's claims of overwhelming evidence. (…) In a 30-page paper published in the Lancet containing more than 300 references, Rory Collins, MBBS, (University of Oxford) and a large group of statin trial leaders presented a massive review of the evidence from clinical trials and observational studies involving statins. (medpagetoday.com 9.9.2016).)

(Anm: Autoimmun myopati ved statinbruk. Det er velkjent at statiner kan ha toksisk effekt på muskulatur, men mindre kjent at de også kan trigge en progredierende autoimmun myopati. Statinassosiert autoimmun myopati kjennetegnes av proksimal muskelsvakhet, antistoffer mot 3-hydroksy-3-metylglutaryl-koenzym A-reduktase (HMGCR) i serum, og nekrose uten lymfocyttinfiltrasjon på muskelbiopsi. Tidsskr Nor Legeforen 2016; 136:1360-2 (27.9.2016).)

(Anm: Statins: 'Harms have been overestimated,' says review (medicalnewstoday.com 9.9.2016).)

(Anm: Benefits of statins have been underestimated and harms overstated, review finds. (…) Richard Horton, editor of the Lancet, said that the controversy over statins had probably harmed the health of thousands of people across the United Kingdom and that the review aimed to better inform patients and their doctors. “We hope the impact will be to correct the public record about the safety and efficacy of statins but also to highlight the problems about unreliable evidence and minority opinions,” Horton told a media briefing at the Science Media Centre in London on Wednesday. BMJ 2016;354:i4893 (Published 09 September 2016).)

(Anm: Bias [baies] -en, - skjevhet i vitenskapelig undersøkelse el. resultat pga. mangelfull systematikk i innsamlingen av data. Etym.: eng., fr. biais helning, tendens. Kilde: ordnett.no.)

(Anm: Bias; (...) valg og vurderinger som på systematisk måte avviker fra det som er faktisk korrekt. Kilde: Store norske leksikon.)

(Anm: Legemiddeletterlevelse (Tas legemidler som foreskrevet?) (Adherence to Medication.) (…) Legemidler virker ikke på pasienter som ikke tar dem. (Drugs don't work in patients who don't take them.)  (NEJM 2005;353:487-497(August 4).)

(Anm: Reduksjon av hjertedød skyldes ikke statiner. Tidsskr Nor Legeforen 2016; 136:895 (15.6.2016).)

(Anm: Forskare: Blygsam överlevnadsfördel av statiner. Behandling med kolesterolsänkande statiner leder bara till en handfull dagar i extra överlevnad, enligt ett okonventionellt sätt att analysera resultat i kliniska prövningar. (dagensmedicin.se 5.11.2015).)

(Anm: Adverse effects of statins Urgent need to establish the true incidence of the side effects of statins BMJ 2014;348:g3650 (Published 11 June 2014).)

(Anm: Gut bacteria may impact body weight, fat and good cholesterol levels (medicalnewstoday.com 11.9.2015).)

(Anm: Flu vaccine effectiveness reduced by use of statins. More than 40% of over-65s in the US use statins to control cholesterol, but two new studies suggest that statin use decreases the effect of the flu vaccine, according to findings published in The Journal of Infectious Diseases. (medicalnewstoday.com 29.10.2015).)

(Anm: England’s chief medical officer asks for review of drug evaluation in wake of statins controversy. The Academy of Medical Sciences, the independent body that represents UK medical science, will carry out a review of the way evidence on drugs is evaluated, after the chief medical officer for England expressed concern that recent controversies had damaged the public’s faith in the way research was carried out and presented. BMJ 2015;350:h3300 (Published 16 June 2015).)

(Anm: Antibiotika (tarmbakterier, probiotika, mikrobiota etc.) (Dysbiose; dysbiosis (also called dysbacteriosis (dysbakteriose)). (mintankesmie.no).)

(Anm: Signaler fra tarmens mikrobiotika til fjerntliggende organer mht. fysiologi og sykdom. (Signals from the gut microbiota to distant organs in physiology and disease.) (Nat Med. 2016 Oct 6;22(10):1079-1089.)

(Anm: - Hadde medisinerne på et tidligere tidspunkt hatt et evolusjonært perspektiv på sin medisinering, ville vi ikke vært i den kritiske situasjon vi er kommet i med hensyn til resistens. (aftenposten.no 22.8.2016).)

(Anm: Antibiotika kan gi flere kroniske sykdommer. (…) Folkehelseinstituttet: – Faren er underkommunisert. – Advarslene er høyst betimelige, sier lege og seniorforsker Merete Eggesbø ved Folkehelseinstituttet. (…) Ifølge Blaser viser ny forskning at det er en sammenheng mellom endringen av den naturlige tarmfloraen vår og utvikling av nye sykdommer som fedme, diabetes, astma,(...) Advarslene er høyst betimelige, sier lege og seniorforsker Merete Eggesbø ved Folkehelseinstituttet. (…) Ifølge Blaser viser ny forskning at det er en sammenheng mellom endringen av den naturlige tarmfloraen vår og utvikling av nye sykdommer som fedme, diabetes, astma, allergi, autisme og mageinfeksjoner. (nrk.no 30.10.2016).)

(Anm: Researchers explore link between gut microbiome and nutrition in autism spectrum disorder. (…) Sharon Donovan, a professor of nutrition at the University of Illinois explains that researchers have started to look at more specific disease states and the microbiome. "We are starting to see links with autism, obesity, diabetes, cardiovascular disease, and almost every disease that is looked at. (news-medical.net 28.4.2017).)

(Anm: Researchers discover new mechanism that causes chronic intestinal inflammation. Researchers at the University Medical Center of Johannes Gutenberg University Mainz and the German Research Center for Environmental Health, Helmholtz Zentrum München have discovered that too much of the oncogene Bcl-3 leads to chronic intestinal diseases. They describe in Nature Communications exactly how it throws the immune system off-balance. Chronic intestinal disorders such as ulcerative colitis and Crohn's disease are caused by the body's own immune defense system. (news-medical.net 28.5.2017).)

(Anm: Forsiktighet kreves ved samtidig forskrivning av antibiotika med psykofarmaka hos eldre pasienter. (…) Antibiotika har flere legemiddelinteraksjoner med psykofarmaka som kan føre til bivirkninger eller behandlingssvikt og betydelig øke kostnadene for behandlinger. (dgnews.docguide.com 3.4.2017).)

(Anm: Antibiotika associeras med högre risk för tarmcancer. (…) Det här är första studien som visar på sambandet mellan antibiotikaanvändning och utveckling av adenom i tjock- och ändtarmen. Studien publiceras i den vetenskapliga tidskriften Gut. (…) Resultatet visade att långvarig antibiotikaanvändning tidigare i livet, i åldern 20 till 59 år, hade samband med diagnostiserade adenom. (lakemedelsvarlden.se 5.4.2017.)

(Anm: Ny forskning viser hvor raskt bakterien blir motstandsdyktig mot antibiotika. E. coli bakterien muteres raskt i kraftig antibiotikadose. Forskere ved Harvard-universitetet har registrert hvor raskt E. coli bakterien klarer å bli motstandsdyktig og overleve antibiotika. I Harvards pressemelding står det at på ti dager overlevde bakterien en antibiotikadose som var 1000 ganger sterkere enn det som vanligvis dreper bakterien. (dagbladet.no 12.9.2016).)

(Anm: Prebiotika kan hjelpe å behandle anstrengelsesutløst astma (Prebiotics could help treat exercise-induced asthma) (medicalnewstoday.com 6.8.2016).)

(Anm: PTSD kan forebygges med tarmbakterier, antyder studie. (PTSD could be prevented with gut microbes, study suggests.) (medicalnewstoday.com 2.5.2016).)

(Anm: PTSD kan være fysisk og ikke bare psykologisk. PTSD may be physical and not only psychological. The part of the brain that helps control emotion may be larger in people who develop post-traumatic stress disorder (PTSD) after brain injury compared to those with a brain injury without PTSD, according to a study that will be presented at the American Academy of Neurology's Sports Concussion Conference in Jacksonville, Fla., July 14 to 16, 2017. "Many consider PTSD to be a psychological disorder, but our study found a key physical difference in the brains of military-trained individuals with brain injury and PTSD, specifically the size of the right amygdala," said Joel Pieper, MD, MS, of University of California, San Diego. "These findings have the potential to change the way we approach PTSD diagnosis and treatment." (medicalnewstoday.com 14.7.2017).)

(Anm: Ny tilnærming kan snart spille nøkkelrolle for å hjelpe veteraner å overvinne PTSD. Novel approach could soon play key role in helping veterans overcome PTSD. A novel approach of using visual and physical stimulus to help military veterans address their traumatic experiences could soon play a significant role in helping British veterans overcome post-traumatic stress disorder (PTSD), thanks to a new Cardiff University research project. (…) The researchers hope that exposure to traumatic memories, enhanced with walking, music and high effect pictures, will eliminate cognitive avoidance – a coping strategy that can contribute to the worsening of PTSD symptoms. (news-medical.net 24.7.2017).)

(Anm: PTSD and cognitive decline linked in 9/11 responders. A study, published in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, investigates the long-term effects of trauma on the cognitive performance of responders to the World Trade Center on 9/11. Post-traumatic stress disorder (PTSD) is a condition that can arise in individuals who have experienced shocking, dangerous, or frightening events. (medicalnewstoday.com 30.8.2016).)

(Anm: Tarmbakterier fjerner autisme i mus. Sykdommer: Ny studie viser at man kan behandle mus med autismesymptomer ved hjelp av ekskrementer fra friske mus. (…) Det var særlig én tarmbakterie, Lactobacillus reuteri, de syke musene manglet. (illvit.no 29.6.2016).)

(Anm: Risikovurdering av kosttilskudd med Lactobacillus Reuteri Protectis. Vitenskapskomiteen for mattrygghet (VKM) har vurdert probiotika som brukes i kosttilskudd til friske barn fra fødsel til tre år. Mangel på kunnskap gjør at VKM ikke kan trekke konklusjoner om hvilke langtidseffekter bruk av denne typen probiotika kan ha for barns helse. Risikovurderingen er gjort på oppdrag for Mattilsynet, med bakgrunn i kravet om mattrygghet. (…) Ukjente langtidseffekter. Mangel på kunnskap om effekt av langvarig bruk gjør at VKM ikke kan vurdere eventuelle langtidseffekter for barn i alderen 0 – 3 år, men VKM peker på at det er en økende erkjennelse av at sammensetningen av bakterier i tarmen hos nyfødte kan ha avgjørende betydning for senere utvikling av tarmflora og immunsystem. (…) Ingen rapporterte bivirkninger. Ingen av studiene som VKM har vurdert har rapportert om bivirkninger eller uønskede korttidseffekter. VKM konkluderer med at det ikke er noen grunn til å anta at bakteriestammen som er vurdert, og i de dosene som er anbefalt, vil kunne ha uønsket effekt på helsa. (vkm.no 11.3.2016).)

(Anm: Semper Dråper Melkesyrebakt 0mnd+. (…) Sammensetning. Solsikkeolje, kokosolje, palmekjerneolje, Lactobacillus reuteri DSM 17938 ( Lactobacillus reuteri protectis ). (boots.no).)

(Anm: - Nye kliniske studier viser «lovende resultater" for autisme (ASD)-behandling. (New clinical trial shows 'promising results' for ASD treatment. The gut microbiota is a fascinating part of the human body; it plays a crucial role in immunity and keeps our bodies healthy. New research suggests that the gut microbiome may even hold the key to a potential treatment for autism. (medicalnewstoday.com 23.1.2017).)

(Anm: Påvirker immunsystemet vår sosiale atferd? (Does the immune system influence our social behavior?) Inntil relativt nylig er hjernen og immunsystemet antatt å arbeide isolert fra hverandre. Dette er nå kjent for ikke å være tilfelle. Denne oppdagelsen reverseres vanlige oppfatninger om at hjernen er "immunprivilegert" og manglet direkte kommunikasjon mellom de to systemene. (medicalnewstoday.com 22.7.2016).)

(Anm: Can the Nervous System Be Hacked? (…) The vagus nerve and its branches conduct nerve impulses — called action potentials — to every major organ. But communication between nerves and the immune system was considered impossible, according to the scientific consensus in 1998. (...) “I was like: C’mon? You’re gonna give a shock and it changes the immune system? I was very skeptical. But finally I agreed to visit Kevin’s lab. I wanted the data, the evidence. I don’t like hot air.”(nytimes.com 23.5.2016).)

(Anm: Spesifikke tarmbakterier reversere autismelignende atferd hos mus (Specific gut bacteria reverse autism-like behavior in mice) Forskere ved Baylor College of Medicine, TX, undersøkte nylig rollen til mors kosthold og tarmbakterier på de sosiale egenskapene til mus. Deres funn vil uten tvil igangsette forskning på muligheten for probiotiske inngrep for en rekke nevrologiske lidelser. (medicalnewstoday.com 17.6.2016).)

(Anm: Big Data Peeps At Your Medical Records To Find Drug Problems. (npr.org 21.7.2014).)

(Anm: Big data and bacteria explain why your diet isn't working. A study published in the journal Cell links the bacteria that live in the human gut - the microbiome - with how the body manages food. "Our research suggests that each person's microbiome is driving food effects on the body," said Eran Elinav, of the Weizmann Institute of Science in Israel, and lead immunologist on the study. (medicalnewstoday.com 20.11.2015).)

(Anm: Use of big data to improve human and animal health. Task force to establish roadmap and recommendations for use of big data in assessment of medicines. Together with the heads of the national competent authorities in the European Economic Area (EEA), known as Heads of Medicines AgenciesExternal link icon (HMA), the European Medicines Agency (EMA) has established a new task force to explore how medicines regulators in the EEA can use big data to support research, innovation and robust medicines development in order to benefit human and animal health. (firstwordpharma.com 23.3.2017).)

(Anm: Pancreatic cancer risk linked to changes in mouth bacteria. The presence of certain bacteria in the mouth may indicate a raised risk for pancreatic cancer - a disease that often begins with no symptoms and for which there is no routine screening test. (…) The researchers suggest the finding may lead to earlier, more precise treatments for pancreatic cancer, a disease with a pitifully low survival rate as it often escapes early diagnosis. (medicalnewstoday.com 20.4.2016).)

(Anm: Pancreatitis often caused by gallstones - also statins increase risk. Idiopathic pancreatitis is often caused by small gallstones that are difficult to observe prior to surgery, shows a study from the University of Eastern Finland. Small gallstones were found in surgery from two out of three idiopathic pancreatitis patients. The study also showed that acute pancreatitis was more common in statin users than non-users. (medicalnewstoday.com 7.12.2015).)

(Anm: Bra kolesterol kan likevel være farlig. (…) Forskerne håper funnene kan bidra til å forklare hvorfor medisiner som er laget for å øke produksjonen av HDL-kolesterol, så langt ikke har vært en suksess. (nrk.no 11.3.2016).)

(Anm: Kolesterolbombe: Det ’sunde’ HDL-kolesterol er slet ikke sundt. Det er forkert at kalde HDL-kolesterol for det gode kolesterol, og vi skal ikke fokusere på HDL i behandling af hjerte-kar-sygdomme. Så klar er meldingen fra professor i klinisk medicin. Andre forskere bakker op. (…) »Resultaterne her vil komme til at præge forskningen i lipoproteiner, hvor fokus vil være på noget andet, måske triglycerider i stedet for HDL. (jyllands-posten.dk 23.3.2016).)

(Anm: Statiner gav effekt även vid låg hjärt-kärlrisk. Förebyggande behandling med statiner minskade risken för hjärt-kärlsjukdom hos lågrisk-patienter med 25 procent. (…) Behandling med kolesterolsänkaren rosuvastin, Crestor, hade en skyddande effekt mot hjärt-kärlsjukdom i patienter som i dag inte har indikation för att behandlas med läkemedlet. Det visar en ny studie publicerad i New England Journal of Medicine. (...) – Det kan säkert uppstå diskussion kring risker med överbehandling och medikalisering. Och det är en viktig diskussion. (…) Däremot upplevde en ökad andel i behandlingsgruppen muskelbesvär och något fler patienter som fick läkemedlet behövde opereras för grå starr. (lakemedelsvarlden.se 4.4.2016).)

(Anm: Reduksjon av hjertedød skyldes ikke statiner. Tidsskr Nor Legeforen 2016; 136:895 (15.6.2016).)

(Anm: Diabetes 2 eksploderer i Norge. Over halvparten av dem som legges inn med akutt hjerteinfarkt har diabetes type 2. Svært mange vet det ikke selv. Verdens helsedag er i år viet kampen mot diabetes, der Norge har en stor jobb å gjøre. (glomdalen.no 5.4.2016).)

(Anm: Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle. (…) While statin therapy lowers ASCVD risk, these HMG-CoA reductase inhibitors are also associated with a risk of myotoxicity (4), and their impact on skeletal muscle health in those with T1DM has not yet been fully examined. Front. Endocrinol. 2016 (19 July 2016).)

(Anm: Paradoks: De raskeste diabetikere dør tidligst. De raskeste type 2-diabetikere har dobbelt så høj dødelighed som de sygeste, og manglende forebyggende medicin synes at være synderen. Derfor skal den kommende nationale handleplan, Diabetesplan 2, sikre, at alle med diabetes får den optimale forebyggende behandling. Det mener Diabetesforeningen. Det lyder umiddelbart paradoksalt, men de raskeste type 2-diabetikere er faktisk dem, der dør tidligst. En dansk undersøgelse viser, at 12,4 procent af de diabetikere, der har mindst problemer med blodsukkeret, dør syv år efter, de får stillet diagnosen diabetes, mens tallet ligger helt nede på 6,5 procent for de sygeste diabetikere. (diabetes.dk 21.11.2016).)

(Anm: Antidepressiva og antipsykotika gir økt risiko for diabetes hos barn og voksne (50 til 700 %) (mintankesmie.no).)

(Anm: Diabetes: Risiko for hjerteinfarkt på grunn av tap av små blodårene rundt hjertet. (Diabetes: Heart attack risk due to loss of small blood vessels around the heart.) (medicalnewstoday.com 24.3.2017).)

(Anm: Pasienter behandlet med antipsykotika (nevroleptika) har signifikant senket platelet complex I aktivitet i mitokondrier i likhet med det som er observert ved idiopatisk Parkinsons sykdom. (...) Antipsykotika (nevroleptika) hemmer kompleks I i elektrontransportkjeden. (Neuroleptic medications inhibit complex I of the electron transport chain. (...) Neuroleptic treated patients have significant depression of platelet complex I activity similar to that seen in idiopathic Parkinson’s disease. Complex I inhibition may be associated with the extrapyramidal side effects of these drugs.) Ann Neurol. 1993;33:512-7).)

(Anm: Pancreatic mitochondrial complex I exhibits aberrant hyperactivity in diabetes. (…) Highlights • Pancreatic mitochondrial complex I shows hyperactivity in diabetes. • Complex I hyperactivity is associated with increased NADH/NAD+ redox imbalance. • Complex I hyperactivity is associated with increased oxidative stress and cell death. • Complex I hyperactivity is linked with compromised cellular anti-oxidative stress capacity such as decreased sirt3 and NQO1 expressions. Biochem Biophys Rep. 2017 Sep;11:119-129.)

(Anm: Effekter av MPTP på serotonerge nevronale systemer og mitokondrie Complex I aktiviteten i den levende hjernen: En PET-studie på bevisste rhesusaper. (Effects of MPTP on Serotonergic Neuronal Systems and Mitochondrial Complex I Activity in the Living Brain: A PET Study on Conscious Rhesus Monkeys. (Effects of MPTP on Serotonergic Neuronal Systems and Mitochondrial Complex I Activity in the Living Brain: A PET Study on Conscious Rhesus Monkeys.) J Nucl Med. 2017 Mar 9. pii: jnumed.116.189159.)

(Anm: Antidepressiva (inkl. SSRI-preparater) og antipsykotika har skadelige effekter på mitokondrier (Mol Cell Biochem 1999;199:103-9).)

(Anm: Mitokondriell dysfunksjon ligger bak kognitive defekter som et resultat av nevral stamcelleutarmning og nedsatt neurogenese. Mitochondrial dysfunction underlies cognitive defects as a result of neural stem cell depletion and impaired neurogenesis. Hum Mol Genet. 2017 Jun 8.)

(Anm: Adenosintrifosfat (ATP) er en energirik kjemisk forbindelse som er involvert i alle energikrevende prosesser i menneskekroppen, som muskelsammentrekning, overføring av signaler i nerver, oppbygging av proteiner, kopiering av arvestoffer med mer. (…) ATP kan oppfattes som en universell energileverandør i alle celler og vev. Livet ville ikke vært mulig uten ATP. Forbindelsen er blitt kalt «livets molekyl». Kilde: Store norske leksikon.)

(Anm: Mitokondriell energimangel fører til hyperproliferasjon av skjelettmuskel-mitokondrier og økt insulinfølsomhet. (...) Vi fremlegger bevis på at mitokondrier bidrar til etiologien (sykdomsårsaken) til metabolsk sykdom. (…) Diabetes er assosiert med svekket glukosemetabolisme i nærvær av overskudd av insulin. PNAS (Proceedings of the National Academy of Sciences) 2017;114(8) (February 21, 2017).)

(Anm: Forskrivninger av midler til behandling av diabetes øker med en tredjedel i løpet av fem år. (Diabetes prescribing rises by a third over five years. The number of prescriptions for drugs that treat type 2 diabetes that were dispensed by pharmacies in England has risen by one third (33%) in five years, according to research carried out by analytic database provider EXASOL.) BMJ 2016;355:i5484 (Published 10 October 2016).)

(Anm: Yngre med type 2-diabetes rammes hårdt. Er man under 45 år, når man får type 2-diabetes, har man ofte allerede tidlige tegn på øjen- og nyreskader, viser nyt dansk studie. (diabetes.dk 14.9.2016).)

(Anm: Selective Serotonin Reuptake Inhibitors Decrease Pancreatic Insulin Secretion in Older Adults and Increase the Risk of Insulin Dependence in Type 2 Diabetes Patients. J Clin Psychiatry. 2016 Aug 2.)

(Anm: Antidepressiva og antipsykotika øker risikoen for hoftebrudd, benskjørhet etc. (- Blant mennesker i alderen 60 år og eldre i Norge hadde de som brukte et antipsykotika hadde dobbelt så stor risiko for å lide av et hoftebrudd enn de som ikke brukte dem.) (mintankesmie.no).)

(Anm: Tanntap (tannløshet) linkes til økt risiko for demens. (Tooth loss linked to an increased risk of dementia.) Våre funn understreker den kliniske betydningen av tannpleie og behandling, spesielt når det gjelder vedlikehold av tenner fra en tidlig alder for å kunne redusere fremtidig risiko for demens. (…) Personer med 10-19, 1-9 og ingen tenner hadde hhv. 62 %, 81 % og 63 % høyere risiko for demens enn personer med > 20 tenner. (medicalnewstoday.com 10.3.2017).)

(Anm: Derfor kan du få demens av diabetes. Diabetes øker risikoen for alzheimer. Den gode nyheten er at du i stor grad kan påvirke risikoen selv. (dagbladet.no 2.7.2016).)

(Anm: FDA advarer om nye impulskontrollproblemer knyttet til legemidlet aripiprazol (Abilify) for psykisk helse (Abilify, Abilify vedlikeh, Aristada) (FDA Drug Safety Communication: FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Maintena, Aristada). (fda.gov 5.5.2016).)

- Statiner og mitokondria. (- . The following causes are proposed: (i) deficiency of coenzyme Q10, an important electron carrier of mitochondrial respiratory chain; (ii) inhibition of respiratory chain complexes; (iii) inhibitory effect on protein prenylation; and (iv) induction of mitochondrial apoptosis pathway. These phenomena could play a significant role in the etiology of statin-induced disease, especially myopathy.)

[Statins and mitochondria].
Postepy Biochem. 2016;62(2):77-84.
The aim of this review is to report on influence of statins on mitochondria function. Statins are serum cholesterol-lowering drugs. They act by competitively inhibiting 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase (EC 1.1.1.88), the first committed enzyme of the mevalonate pathway. In this way, statins inhibit the endogenous cholesterol synthesis. Emerging evidence suggest that statins impair mitochondria, which is demonstrated by abnormal mitochondrial morphology, decreased oxidative phosphorylation capacity and yield, decreased mitochondrial membrane potential and activation of intrinsic apoptotic pathway. Mechanisms of statin-induced mitochondrial dysfunction are not fully understood. The following causes are proposed: (i) deficiency of coenzyme Q10, an important electron carrier of mitochondrial respiratory chain; (ii) inhibition of respiratory chain complexes; (iii) inhibitory effect on protein prenylation; and (iv) induction of mitochondrial apoptosis pathway. These phenomena could play a significant role in the etiology of statin-induced disease, especially myopathy. Studies on statin-induced mitochondrial apoptosis could be useful in developing a new cancer therapy. (…)

(Anm: Role of mitochondrial DNA variation in the pathogenesis of diabetes mellitus. Mitochondria are crucial intracellular organelles where ATP and reactive oxygen species are generated via the electron transport chain. They are also where cellular fate is determined. There is a growing body of evidence that mitochondrial dysfunction plays an important role in the pathogenesis of type 2 diabetes. (…)  Front Biosci (Landmark Ed). 2016 Jun 1;21:1151-67.)

(Anm: Usunt kosthold koster oss 154 milliarder hvert år. Hadde befolkningen fulgt kostrådene fra myndighetene, ville samfunn og folk fått en gevinst på 154 milliarder i året, ifølge Helsedirektoratet. (…) I tillegg kommer de samlede helsegevinstene i form av flere leveår og bedret livskvalitet for den enkelte, med samlet anslått verdi på 136 milliarder kroner årlig. (aftenposten.no 15.3.2016).)

(Anm: Statins associated with lower risk of cardiac events for some patients, not others. Cholesterol-lowering statins were associated with lower risk for major cardiac events in some patients with preexisting ischemic heart disease but not in others, according to an article published online by JAMA Internal Medicine. (…) The authors note a number of study limitations, including restricting the study to patients with preexisting IHD and limited generalizability. "Our results do not provide support for a blanket principle that lower LDL-C is better for all patients in secondary prevention," the study concludes.  (medicalnewstoday.com 22.6.2016).)

(Anm: Muligt gennembrud i behandling af åreforkalkning. Et »fantastisk lovende« studie på mus viser, at behandling af åreforkalkning med stoffet cyclodextrin kan reducere allerede etableret åreforkalkning – også selvom musene fortsætter med at spise en fedtholdig kost. (…) I et studie, der netop er publiceret i Science Translational Medicine, viser en gruppe internationale forskere ledet af professor og læge Eicke Latz fra Bonn Universitet, at stoffet cyclodextrin (CD) kan bruges til at opløse kolesterol i tilstoppede pulsårer hos mus og dermed kan være en effektiv behandling af åreforkalkning. (…) nuværende behandlinger med eksempelvis kolesterolsænkende medicin kun er effektiv hos nogle patienter. (videnskab.dk 7.4.2016).)

- Tilbaketrekkingen av statin-artikkel er ikke i offentlighetens interesse: bedre karakterisering av nytte og risiko er avgjørende

Adverse effects of statins (Bivirkninger av statiner)
Retraction of statins article is not in the public interest: better characterisation of benefits and risks is crucial (Tilbaketrekkingen av statin-artikkelen er ikke i offentlighetens interesse: bedre karakterisering av nytte og risiko er avgjørende)
(18 June 2014) Abramson and colleagues highlight uncertainties about adverse effects of statins for the primary prevention of cardiovascular disease in patients at low absolute cardiovascular risk.1 2 There is a substantial discrepancy between observational studies and randomised controlled trials (RCTs) regarding the reporting of adverse effects of statins. This could be the result of under-reporting of “mild” adverse effects in RCTs or it could be a true representation of the clinical picture. Our clinical experience is that patients are reluctant to report adverse effects and many discontinue treatment without saying so. A recent systematic review confirms this—only 49% (95% CI 48.9% to 49.2%) of patients were adherent at one year on the basis of observational data, whereas RCTs report that 90.3% (89.8% to 90.8%) continue to be adherent.3 RCTs of adherence enhancing strategies show a substantial reduction in adherence (<50%) between six and 24 months.4 Although adherence is only a marker for adverse effects and patients discontinue for other reasons, this problem needs to be further explored because poor adherence is associated with increased cardiovascular mortality.5 (…)

(Anm: Statins 'lower aggression in men but increase it in women' (…) According to Dr. Golomb, previous studies have associated low cholesterol levels with greater risk of violent actions and death from violence. What is more, she notes there have been reports of people prescribed statins experiencing irritability and aggression. (medicalnewstoday.com 2.7.2015).)

(Anm: Report of the independent panel considering the retraction of two articles in The BMJ. BMJ 2014; 349 (15 August 2014).)

(Anm: Bivirkninger og bivirkningsovervåkning (legemiddelsikkerhet) (mintankesmie.no).)

(Anm: Skader og ulykker i Norge. 2500 dør og 300 000 behandles årlig på sykehus for skader. Mange alvorlige skader er knyttet til alkohol og andre rusmidler, fall og trafikk. (…) Hva er et forgiftningsdødsfall? (fhi.no 14.12.2016).)

(Anm: Medisinske feil — den tredje viktigste dødsårsaken i USA. Hvert år oppstår mer enn 250 000 dødsfall i USA som et resultat av medisinske feil. Medisinske feil inkluderes ikke i dødsattester eller i rangeringen av dødsårsaker. (Medical error—the third leading cause of death in the US.) BMJ 2016;353:i2139 (Published 03 May 2016).)

(Anm: Scientists identify mechanism behind statin-induced muscle weakness. ew research suggests that muscle weakness and related side effects that can arise from statin use is likely due to the drug's effect on the energy production centers, or mitochondria, of muscle cells. The researchers, from Radboud University Nijmegen Medical Center in the Netherlands, report their findings in the journal Cell Metabolism. (…) However, for around 25% of patients, statins can give rise to unpleasant side effects in the form of muscle weakness, pain and cramps, without any sign of damage to the tissue. These side effects can impair quality of life and often cause patients to stop taking the drugs. (medicalnewstoday.com 2.9.2015).)

(Anm: Statins: numbers needed to treat and personal decision making BMJ 2014;349:g4980 (05 August 2014).)

(Anm: Results of investigation into statin side effects due by end of year BMJ 2015;350:h957 (Published 17 February 2015).)

(Anm: Don’t Give More Patients Statins (nytimes.com 13.11.2013).)

(Anm: Reconnecting the Dots — Reinterpreting Industry–Physician Relations. N Engl J Med 2015; 372:1860-1864 (May 7, 2015).)

- Uheldige effekter av statiner

Adverse effects of statins
Muscular adverse effects are common with statins
.
Peter C Gøtzsche, professor
BMJ 2014;348:g3724 (Published 11 June 2014)
The 2011 Cochrane review of statins for the primary prevention of cardiovascular disease reported a risk ratio of 1.03 for muscle pain—3% more patients developed muscle pain on the drug than on placebo.1 However, industry funded randomised trials are notoriously unreliable when it comes to the harms of drugs.2 The results of a publicly funded randomised trial from 2012 on the impact of statins on energy and exertional fatigue could be interpreted as 20% of men and 40% of women experiencing reduced energy or increased exertional fatigue.3

I therefore wonder why Rory Collins has pressured the BMJ in a most unacademic way for having published a paper based on a cohort study that reported a similar incidence of harms.4 5 He has even called for a retraction of the paper, just like drug companies often do when a paper appears that could threaten their sales.2 Collins and his colleagues publish meta-analyses based on company data to which no one else has access because of the confidentiality clauses they have accepted.

I believe that science ceases to exist when no one else than those who have conflicts of interest are allowed to see the data. (...)

(Anm: Ignoring adverse experiences of people taking statins. In primary prevention trials statins slightly reduce atherosclerotic events but not total serious adverse events.1 Another paradox is that many patients have muscle pain, fatigue, or weakness that resolves when they stop the drug, yet clinical trialists do not believe in a causal association. BMJ 2016;353:i2030 (Published 12 April 2016).)

(Anm: Non-cardiovascular effects associated with statins. BMJ 2014;349:g3743 (17 July 2014).)

(Anm: Rosuvastatin: winner in the statin wars, patients’ health notwithstanding BMJ 2015;350:h1388 (Published 17 March 2015).)

(Anm: Crestor (rosuvastatin) (dailymed.nlm.nih.gov).)

(Anm: NICE sticks to its advice to drop threshold for prescribing statins. BMJ 2014;349:g4694(18 July 2014).)

(Anm: Fyra av tio engelsmän kan få statiner. Fyrtio procent av den vuxna engelska befolkningen kommer att kunna erbjudas blodfettsänkande statiner på recept. (dagensmedicin.se 22.7.2014).)

(Anm: Mass treatment with statins - Editorials. BMJ 2014;349:g4745 (Published 23 July 2014).)

(Anm: Some recommendations challenged in updated cholesterol treatment guideline (medicalnewstoday.com 18.8.2014).)

(Anm: The effects of statin medications on aerobic exercise capacity and training adaptations. The incidence of myopathy increases dramatically in statin users who also exercise, likely limiting the positive impact of this lifesaving medication. New evidence also indicates that statin use can directly compromise aerobic exercise capacity; however, we are just beginning to understand the interactions of statins with exercise training and adaptations. (…) Sports Med. 2014 Nov;44(11):1519-30.)

- Statiner kan öka diabetesrisk med 50 procent

Statiner kan öka diabetesrisk med 50 procent
dagensmedicin.se 6.3.2015
Risken för diabetes vid användning av de kolesterolsänkande statinerna verkar öka i större utsträckning än vad man tidigare trott. Åtminstone enligt en ny studie som publicerats i tidskriften Diabetologia.
Statiner minskar risken för hjärt-kärlsjukdomar men innebär också en ökad risk för att utveckla diabetes. Under de senaste åren har ett antal studier och meta-analyser kopplat statinbehandling till en ökad risk för diabetes.

Nyligen publicerades en finländsk populationsstudie där man följt 8 749 icke-diabetiker, varav 2 142 personer på statinbehandling. Vid en sexårsuppföljning såg forskarna att statinbehandling ökade risken för typ 2 diabetes med 46 procent, jämfört med en jämförbar grupp som inte fick statiner. Dessutom minskade insulinkänsligheten och insulinutsöndringen hos dem som fick statiner jämfört med dem som inte fick statiner.

Atorvastatin och simvastatin ökade diabetesrisken och effekten var dosberoende. Andra statiner (pravastatin, fluvastatin och lovastatin) gav ingen ökad diabetesrisk, men antalet patienter som fick dessa läkemedel var för lågt för att kunna avgöra deras individuella risker, enligt forskarna.

Resultaten visar, enligt forskarna, att risken för diabetesutveckling vid statinbehandling är större än vad som tidigare rapporterats, och att av de statiner som användes i studien var det atorvastatin och simvastatin som stod för riskökningen. (…)

(Anm: Increased risk of diabetes with statin treatment is associated with impaired insulin sensitivity    and insulin secretion: a 6 year follow-up study of the METSIM cohort. Diabetologia 2015 (published online 4 mars 2015.)

(Anm: Statin Drugs May Increase Risk Of Diabetes (medicalnewstoday.com 24.5.2013).)

(Anm: Study shows that use of statins increases risk of developing diabetes by 46%, even after adjustment for confounding factors (medicalnewstoday.com 20.4.2015).)

(Anm: Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle. (…) While statin therapy lowers ASCVD risk, these HMG-CoA reductase inhibitors are also associated with a risk of myotoxicity (4), and their impact on skeletal muscle health in those with T1DM has not yet been fully examined. Front. Endocrinol. 2016 (19 July 2016).)

- Subklinisk hypotyreose-assosiert risiko for diabetes mellitus er fremtredende bare ved statin bruk.

Hypothyroidism Is a Risk Factor for New-Onset Diabetes Mellitus: A Cohort Study
Diabetes Care 2015 (Published online before print June 12)
OBJECTIVE To identify risk factors for the development of statin-associated diabetes mellitus (DM).

RESEARCH DESIGN AND METHODS The study was conducted in two phases. Phase one involved high-throughput in silico processing of a large amount of biomedical data to identify risk factors for the development of statin-associated DM. In phase two, the most prominent risk factor identified was confirmed in an observational cohort study at Clalit, the largest health-care organization in Israel. Time-dependent Poisson regression multivariable models were performed to assess rate ratios (RRs) with 95% CIs for DM occurrence. (…)

CONCLUSIONS Hypothyroidism is a risk factor for DM. Subclinical hypothyroidism-associated risk for DM is prominent only upon statin use. Identifying and treating hypothyroidism and subclinical hypothyroidism might reduce DM risk. Future clinical studies are needed to confirm the findings. (…)

- Statiner og immunmediert nekrotiserende myopati

1. Atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, simvastatin – Immunmedieret nekrotiserende myopati (IMNM) (EPITT nr. 18140)
ema.europa.eu (22. januar 2015 EMA/PRAC/63323/2015 Udvalget for Risikovurdering inden for Lægemiddelovervågning)
PRAC's anbefalinger om signaler til ajourføring af produktinformationen Vedtaget den 6.-9. januar 2015, PRAC

Efter gennemgang af den foreliggende dokumentation fra litteraturen vedtog PRAC, at indehaverne af markedsføringstilladelse for lægemidler indeholdende atorvastatin, simvastatin, pravastatin, fluvastatin, pitavastatin eller lovastatin inden 2 måneder skal indsende en ansøgning om ændring af produktinformationen som beskrevet nedenfor (ny tekst er understreget):

Produktresumé: Punkt 4.4 – Særlige advarsler og forsigtighedsregler vedrørende brugen:

I meget sjældne tilfælde er beskrevet immunmedieret nekrotiserende myopati (IMNM) under eller efter behandling med visse statiner. Klinisk er IMNM karakteriseret ved vedvarende proksimal muskelsvaghed og forhøjet serum-kreatininkinase, som begge vedvarer trods seponering af statinbehandlingen.

Punkt 4.8 – Bivirkninger: Muskuloskeletale lidelser

Ikke kendt: Immunmedieret nekrotiserende myopati (se pkt. 4.4)
Indlægsseddel: Afsnit 2:

Fortæl det til lægen eller på apoteket, hvis du har vedvarende muskelsvaghed. Det kan være nødvendigt med ekstra prøver og lægemidler for at stille diagnosen og behandle dette.

Afsnit 4: Bivirkninger med ukendt hyppighed: Vedvarende muskelsvaghed. (…)

(Anm: Muskelsykdom (myopati) (nevro.legehandboka.no 30.10.2014).)

(Anm: Statiner – Immunmediert nekrotiserende myopati (IMNM) Denne oppdateringen skal søkes for nasjonalt godkjente legemidler som inneholder atorvastatin, simvastatin, pravastatin, fluvastatin, pitavastatin eller lovastatin der preparatomtalen og pakningsvedlegget ikke inneholder informasjon om IMNM. (slv.no 24.2.2015).)

(Anm: Autoimmun myopati ved statinbruk. Det er velkjent at statiner kan ha toksisk effekt på muskulatur, men mindre kjent at de også kan trigge en progredierende autoimmun myopati. Statinassosiert autoimmun myopati kjennetegnes av proksimal muskelsvakhet, antistoffer mot 3-hydroksy-3-metylglutaryl-koenzym A-reduktase (HMGCR) i serum, og nekrose uten lymfocyttinfiltrasjon på muskelbiopsi. Tidsskr Nor Legeforen 2016; 136:1360-2 (27.9.2016).)

(Anm: Widespread Muscle Involvement in Necrotizing Myopathy. Findings indicate immune-mediated necrotizing myopathy is a 'unique form of myositis' (medpagetoday.com 26.9.2016).)

(Anm: Statin Therapy Alters Lipid Storage in Diabetic Skeletal Muscle. (…) While statin therapy lowers ASCVD risk, these HMG-CoA reductase inhibitors are also associated with a risk of myotoxicity (4), and their impact on skeletal muscle health in those with T1DM has not yet been fully examined. Front. Endocrinol. 2016 (19 July 2016).)

(Anm: Inflammatory Muscle Diseases. Inflammatory myopathies are the largest group of potentially treatable myopathies in children and adults. They constitute a heterogeneous group of disorders that are best classified, on the basis of distinct clinicopathologic features, in four subtypes: dermatomyositis, polymyositis, necrotizing autoimmune myositis, and inclusion-body myositis (throughout this review, I use this term to refer specifically to sporadic inclusion-body myositis). N Engl J Med 2015; 372:1734-1747 (April 30, 2015).)

(Anm: Mitochondria, Muscle Health, and Exercise with Advancing Age. Physiology (Bethesda). 2015 May;30(3):208-223.)

(Anm: Coenzyme Q10 remarkably improves the bio-energetic function of rat liver mitochondria treated with statins.: Eur J Pharmacol. 2015 May 22. pii: S0014-2999(15)30037-6. [Epub ahead of print].)

(Anm: Mitokondrie myopati. Mitokondriene er cellenes ”kraftverk” og derfor klarer ikke slike mitokondrier å produsere nok energi til muskelarbeidet i hele kroppen. Andre energikrevende celler enn tverrstripet muskelceller kan også rammes og gi symptomer fra mange organer. Det er ofte muskelsmerter ved anstrengelse og økt trettbarhet som er viktigste kliniske funn. En muskelbiopsi kan undersøkes med enzymhistokjemiske og elektronmikroskopiske metoder som kan gi diagnostiske funn. Enkelte former for mitokondriemyopati kan også verifiseres genetisk eller biokjemisk. Det er viktig å gjøre funksjonsundersøkelse (enzymmåling kombinert med fysisk belastning) i forbindelse med mistanke om mitokondriemyopati.(unn.no 21.4.2009 ).)

(Anm: The effects of statin medications on aerobic exercise capacity and training adaptations. The incidence of myopathy increases dramatically in statin users who also exercise, likely limiting the positive impact of this lifesaving medication. New evidence also indicates that statin use can directly compromise aerobic exercise capacity; however, we are just beginning to understand the interactions of statins with exercise training and adaptations. (…) Sports Med. 2014 Nov;44(11):1519-30.)

- Mellom ti og tyve prosent får milde, men ubehagelige muskelsmerter som følge av medisinen

Kan kutte bivirkninger for tusener av nordmenn
vg.no 22.6.2014
Ny norsk forskning kan ha løst gåten bak alvorlige bivirkninger

En del av dem som går på kolesterolsenkende medisin, får alvorlige - i verste fall dødelige - bivirkninger. Ny forskning ved Universitetet i Oslo kan bidra til å løse gåten. (...)

Statinene påstås generelt å gi lite bivirkninger, men mellom ti og tyve prosent får milde, men ubehagelige muskelsmerter som følge av medisinen. Symptomene kan arte seg som ømhet og stølhet i musklene, kanskje også som influensalignende symptomer.

En mindre andel får også langt mer alvorlige muskelbivirkninger, såkalt rabdomyolyse: En tilstand med akutt ødeleggelse av store mengder muskelceller. Akutt nyresvikt er en vanlig komplikasjon som følger med, og tilstanden kan i verste fall være dødelig. (...)

Forskerne fant blant annet at statinene har effekt på et spesielt enzym, legumain, som kan spille en viktig rolle knyttet til celleoverlevelse og celledød.

- Funnet kan bidra til å forklare hvorfor enkelte opplever akutt muskelcelledød ved bruk av statiner, forklarer Smith. (...)

PS: Statiner kan også gi andre bivirkninger enn muskelplager, som noe økt risiko for diabetes, glemsomhet og forvirring, samt mageplager som forstoppelse eller diaré.

(Anm: Simvastatin enhances human osteoblast proliferation involved in mitochondrial energy generation. Eur J Pharmacol. 2013 Jun 11 (mintankesmie.no).)

(Anm: Muskelsykdom (myopati) (nevro.legehandboka.no).)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

(Anm: Linking telomere loss and mitochondrial dysfunction in chronic disease. (…) Drawing a mechanistic connection between telomere function and mitochondria biology will provide a broader perspective for understanding the pathophysiology of diseases and their relation to the aging process, and may provide opportunities for new possible treatments. Front Biosci (Landmark Ed). 2017 Jan 1;22:117-127.)

(Anm: Extreme short and long telomeres linked to increased cancer risk (news-medical.net 5.4.2017).)

(Anm: Scientists discover master regulator of cellular aging. (…) "Telomeres represent the clock of a cell," said TSRI Associate Professor Eros Lazzerini Denchi, corresponding author of the new study, published online in the journal Science. "You are born with telomeres of a certain length, and every time a cell divides, it loses a little bit of the telomere. Once the telomere is too short, the cell cannot divide anymore." (medicalnewstoday.com 13.1.2017).)

(Anm: Betennelser endrer mitokondrier til giftige fabrikker. Å lære hvordan å kontrollere betennelser kan ha store implikasjoner for behandlingen av mange sykdommer. Banebrytende forskning oppdager hvordan makrofager endrer mitokondriene til giftige kjemisk-produserende betennelsespromotører. (Inflammation turns mitochondria into toxic factories. Learning how to control inflammation could have huge implications for the treatment of many diseases. Breaking research discovers how macrophages turn mitochondria into toxic chemical-producing inflammation-promoters.) (medicalnewstoday.com 25.9.2016).)

(Anm: Research may show new ways to repress inflammation at outset. (…) Professor Alexander Weber of the Interfaculty Institute of Cell Biology says the enzyme - Bruton's tyrosine kinase or BTK - is switched on when an inflammation occurs in the body, playing a key role in the inflammation's subsequent development. (medicinenet.com 21.2.2017).)

(Anm: Ørsmå mitokondrier spiller en svært stor rolle mht. menneskets evolusjon og sykdom (Tiny mitochondria play outsized role in human evolution and disease.) (medicalnewstoday.com 25.9.2015).)

(Anm: Understanding mitochondrial complex I assembly in health and disease. Biochim Biophys Acta. 2012 Jun;1817(6):851-62. Epub 2011 Sep 2.)

(Anm: Exercise increases mitochondrial complex I activity and DRP1 expression in the brains of aged mice. Abstract. Exercise is known to have numerous beneficial effects. Recent studies indicate that exercise improves mitochondrial energetics not only in skeletal muscle but also in other tissues. (…) Our results suggest that exercise training in old mice can improve brain mitochondrial function through effects on electron transport chain function and mitochondrial dynamics without increasing mitochondrial biogenesis. Exp Gerontol. 2017 Jan 17. pii: S0531-5565(16)30505-8. [Epub ahead of print].)

(Anm: Exercise prevents cellular aging by boosting mitochondria (medicalnewstoday.com 8.3.2017).)

(Anm: Trening er best for å redusere tilbakefall av brystkreft. Exercise is best for reducing breast cancer recurrence. The research was conducted by Dr. Ellen Warner, of the Sunnybrook Health Sciences Centre in Canada, in collaboration with coauthor Dr. Julia Hamer, and the findings were published in the Canadian Medical Association Journal (CMAJ). (medicalnewstoday.com 22.2.2017).)

(Anm: Selective inhibition of deactivated mitochondrial complex I by biguanides. Biochemistry. 2015 Feb 26. [Epub ahead of print].)

(Anm: Exercise increases mitochondrial complex I activity and DRP1 expression in the brains of aged mice. Abstract. Exercise is known to have numerous beneficial effects. Recent studies indicate that exercise improves mitochondrial energetics not only in skeletal muscle but also in other tissues. (…) Our results suggest that exercise training in old mice can improve brain mitochondrial function through effects on electron transport chain function and mitochondrial dynamics without increasing mitochondrial biogenesis. Exp Gerontol. 2017 Jan 17. pii: S0531-5565(16)30505-8. [Epub ahead of print].)

(Anm: Exercise prevents cellular aging by boosting mitochondria (medicalnewstoday.com 8.3.2017).)

(Anm: Trening er best for å redusere tilbakefall av brystkreft. Exercise is best for reducing breast cancer recurrence. The research was conducted by Dr. Ellen Warner, of the Sunnybrook Health Sciences Centre in Canada, in collaboration with coauthor Dr. Julia Hamer, and the findings were published in the Canadian Medical Association Journal (CMAJ). (medicalnewstoday.com 22.2.2017).)

- Nytten ved å bruke statiner for lisensiert indikasjon oppveier risikoen hos de fleste pasienter

Benefits of statins outweigh risks, says medicines regulator’ (Nytte oppveier risiko for statiner, sier legemiddelkontroll)
theguardian.com 30.5.2014
MHRA says evidence from clinical trials shows statins can save lives by reducing risk of heart attacks and need for surgery (…)

MHRAs nye oversikt over bevis erkjenner at statiner ", som alle legemidler", kan forårsake bivirkninger hos noen mennesker - stort sett milde og oftest muskelrelatert - men sier at de fleste bør fortsette å ta legemidlene. (The MHRA's new overview of evidence recognises statins, "like all medicines", can cause side effects in some people – mostly mild and most frequently muscle-related – but says most people should continue to take the drugs.)

De minner forskrivere om å råde pasienter til å søke rask legehjelp dersom de opplever muskelproblemer når de tar legemidlet. For noen pasienter kan avslutning av behandling være hensiktsmessig. Dersom behandlingen med statiner må fortsette til tross for muskelproblemer bør forskrivere vurdere å bruke en lavere statindose eller bytte til et annet statin, er rådet. (It reminds prescribers to advise patients to seek prompt medical attention if they experience muscle problems while on the drugs. For some patients stopping statin treatment may be appropriate. If statin treatment must be continued despite the muscle problems, prescribers should consider using a lower statin dose or switching to a different statin, the advice says.)

"Nytten ved å bruke statiner for lisensiert indikasjon oppveier risikoen hos de fleste pasienter", er det anført. Men "potensiell nytte og skader" må vurderes i hvert enkelt tilfelle. (…) ("The benefits of using any statin in its licensed indication outweigh the risks in most patients", it says. But the "potential benefits and harms" must be considered in each case.)

(Anm: Drug regulator advises patients to keep taking statins BMJ 2014;348:g3671  (3 June 2014).)

(Anm: Heart attacks could be reduced by rethinking the way we prescribe statins (medicalnewstoday.com 11.3.2016).)

- Statiner for alle over 50?

Statins may lead to decline in physical activity among the elderly, researchers warn (Statiner kan føre til redusert i fysisk aktivitet blant eldre, advarer forskere )
pulsetoday.co.uk 10.6.2014
Elderly men who take statins tend to take part in less physical activity than men the same age who do not take them, which could be related to muscle problems brought on as a side effect of the cholesterol-lowering drugs, US researchers have concluded.

In a study published in JAMA Internal Medicine, he researchers looked at activity levels in a seven-year study of over 3,000 men aged 65 years or older, of whom around a quarter were taking statins at baseline.

After taking into account differences in medical history and other potential confounding factors, they found new users of statins had a significantly faster decline in their physical activity over time than never-users – with their self-reported activity on the PASE (Physical Activity Scale for the Elderly) falling by an extra 0.9 points each year, on average.  (…)

(Anm: Statins and Physical Activity in Older Men The Osteoporotic Fractures in Men Study ONLINE FIRST. JAMA Intern Med. 201|4 (Published online June 09, 2014.) http://archinte.jamanetwork.com/article.aspx?articleid=1878470

Adverse effects of statins Uheldige effekter av statiner (Uheldige effekter av statiner)
Editorial
BMJ 2014;348:g3306 (Published 15 May 2014)
The BMJ and authors withdraw statements suggesting that adverse events occur in 18-20% of patients

In October last year we published an article by John Abramson and colleagues that questioned the evidence behind new proposals to extend the routine use of statins to people at low risk of cardiovascular disease.1 Abramson and colleagues set out to reanalyse data from the Cholesterol Treatment Trialists’ (CTT) Collaboration. Their contention was that the benefits of statins in low risk people were less than has been claimed and the risks greater. (...)

This editorial aims to alert readers, the media, and the public to the withdrawal of these statements so that patients who could benefit from statins are not wrongly deterred from starting or continuing treatment because of exaggerated concerns over side effects. (...)

The true incidence of adverse events from use of statins in people at low risk continues to be disputed. Data compiled by the CTT Collaboration show that rates of adverse effects are similar in the active and the placebo arms in trials of statins. However, generalising from clinical trials to wider populations may be problematic because of patient selection; for example, exclusion of older patients, patients with co-morbid conditions or potential drug-drug interactions, and women. In addition, when compared with the full clinical study reports, published accounts of clinical trials in medical journals report only a minority of adverse events.4 Access to the full data from trials of statins would help determine the rates of serious adverse events in statin and control groups; although in their correction Abramson and colleagues say that this probably won’t help to determine the frequency of statin related events that are less than serious. (...)

(Anm: Editorials. Statins for people at low risk. Independent review of the trial data is an essential next step. BMJ 2015;351:h3908 (Published 21 July 2015).)

Correction
Should people at low risk of cardiovascular disease take a statin?

BMJ 2014;348:g3329 (Published 15 May 2014)
Correction to Should people at low risk of cardiovascular disease take a statin?

The conclusion and summary box of this Analysis article by Abramson and colleagues (BMJ 2013;347:f6123, doi:10.1136/bmj.f6123) stated that side effects of statins occur in about 18-20% of patients. The authors withdraw this statement. Although it was based on statements in the referenced observational study by Zhang and colleagues, that “the rate of reported statin-related events to statins was nearly 18%,”1 the article did not reflect necessary caveats and did not take sufficient account of the uncontrolled nature of the study. (…)

Uppgift om statiner dras tillbaka
lakemedelsvarlden.se 20.5.2014
Uppgifter om biverkningar av statiner som publicerats i British Medical Journal dras tillbaka.

I oktober 2013 publicerades två studier om blodfettssänkande statiner i den vetenskapliga tidskriften British Medical Journal, BMJ. Nu har delar av dessa dragits tillbaka eftersom redaktionsledningen anser att resultaten inte är tillförlitliga och att de överdriver risken med läkemedlen. (...)

Hon skriver i en kommenterade artikel att redaktörerna inte hade uppmärksammat detta och släppt igenom publiceringarna. Hon säger också till BBC att det än så länge inte är hela artiklarna som dras tillbaka utan de felaktiga siffrorna, men att en oberoende expertpanel ska granska hela studierna för att avgöra deras framtid. (...)

Statins for all over 50? No (Statiner for alle over 50: Nei)
Editor's Choice
BMJ 2013;347:f6412 (Published 23 October 2013)
A review of statins for primary prevention of cardiovascular disease could alter guidance for those with a 10 year risk of less than 10%. John Abramson and colleagues argue that statins have no overall health benefit in this population and that prescribing guidelines should not be broadened (...)

Should people at low risk of cardiovascular disease take a statin? (Bør mennesker med lav risiko for kardiovaskulær sykdom bruke statiner?)
BMJ 2013;347:f6123 (22 October 2013)
A review of statins for primary prevention of cardiovascular disease could alter guidance for those with a 10 year risk of less than 10%. John Abramson and colleagues argue that statins have no overall health benefit in this population and that prescribing guidelines should not be broadened (...)

Statins: Is It Really Time to Reassess Benefits and Risks? (Statiner: Er det i virkeligheten på tide at man revurderer nytte og risiko?)
Allison B. Goldfine, M.D.
N Engl J Med 2012; 366:1752-1755 (May 10, 2012)
No drug provides health benefits without some degree of risk, and risk–benefit assessments require ongoing review as new data become available. This is certainly the case for the use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors — statins — and the risk of new-onset diabetes.

Cardiovascular disease is the leading cause of illness and death in patients with type 2 diabetes. There is no doubt that for persons who have had an acute coronary syndrome or who have other risk factors for atherosclerotic coronary artery disease, statins effectively reduce the risks of death from any cause, death due to cardiovascular disease, fatal myocardial infarction, the need for revascularization, and stroke (see figure Effect of Statins on Cardiovascular Event Rates, According to Reduction in LDL Cholesterol of 1 Millimole per Liter.). Over a period of 4 years of statin use, a reduction of 1 mmol per liter (39 mg per deciliter) in the level of low-density lipoprotein (LDL) cholesterol translates into a 9% reduction in the risk of death from any cause among patients with diabetes and a 13% reduction among those without diabetes.1 Benefits are realized within the first year of use but increase over time. Few drugs have had such a dramatic effect on health outcomes. (...)

(Anm: Risk of hemorrhage with statins and stroke prevention drug combination. Two commonly used statins can increase the risk of hemorrhage when combined with dabigatran etexilate, a drug often used for preventing stroke in patients with atrial fibrillation, according to a study in CMAJ (Canadian Medical Association Journal). (medicalnewstoday.com 22.11.2016).)

- Pfizer i USA saksøkes av tusenvis

Pfizer i USA saksøkes av tusenvis
dagensmedisin.no 8.8.2014
1000 pasienter saksøker Pfizer i USA.

Kolesterolmedisinen Lipitor markedsføres av Pfizer, og er et av verdens mestselgende legemidler noensinne. 

Ifølge Reuters saksøker nå nær 1000 amerikanske pasienter selskapet.

Det var i 2012 at amerikanske legemiddelmyndigheter, FDA, advarte om at Lipitor og andre kolesterolsenkende medisiner, såkalte statiner, ble knyttet til hukommelsestap og en mindre forhøyet risiko for å utvikle diabetes.

Pfizer ble deretter saksøkt av flere som mener Pfizer fullt ut har vært klar over disse negative bivirkningene og at selskapet hadde plikt til å informere offentligheten om dette.

Nå er antallet søksmål steget fra 65 til nærmere 1000.

Ifølge Reuters avviser Pfizer beskyldningene. Rettsaken er planlagt i juli neste år. (…)

(Anm: Legemiddelerstatninger (søksmål) (mintankesmie.no).)

(Anm: Norsk pasientskadeerstatning (NPE). (mintankesmie.no).)

(Anm: Gruppesøksmål (massesøksmål) (mintankesmie.no).)

(Anm: Folkemedisinen som kan gi deg hukommelsessvikt: - Blir framstilt som helt ufarlig. FETT BLOD: Lipider i blodet, fettstoffer, er essensielt, men for mye kan skade blodårene, føre til forkalkninger og øke risikoen for hjerte- karsykdom. Høyt kolesterol, høyt nivå av det dårlige LDL-kolesterolet, øker risikoen for åreforkalninger. Det er hvertfall den gjeldende teorien. Bivirkningene er underrapportert, mener ekspert. (dagbladet.no 2.3.2016).)

(Anm: Statin Therapy and Risk of Acute Memory Impairment. (…) Conclusions and Relevance: Both statin and nonstatin LLDs were strongly associated with acute memory loss in the first 30 days following exposure in users compared with nonusers but not when compared with each other. Thus, either all LLDs cause acute memory loss regardless of drug class or the association is the result of detection bias rather than a causal association. JAMA Intern Med. 2015 Jun 8. [Epub ahead of print].)

(Anm: 'Statins linked to acute memory loss - but are unlikely to cause it'.  (…) The results of the study reveal a nearly four-fold increase in the risk of developing acute memory loss in the 30 days immediately following the first use of a statin - as compared with non-users of lipid-lowering drugs.  The dose-response analysis also showed a statistically significant trend, the authors add. (medicalnewstoday.com 9.6.2015).)

- Statinuenigheten: For farlig eller verdt risikoen?

The Statin Controversy: Too Dangerous or Worth the Risk? (Statinuenigheten: For farlig eller verdt risikoen?)
ivanhoe.com 11.5.2012
(Ivanhoe Newswire) -- A meta-analysis of multiple trials has left the medical world and patients concerned about statins and whether or not their benefits are worth their potentially harmful side effects.

Statins are a class of drugs that lower the amount of LDL cholesterol in the body by blocking the enzyme in the liver that makes cholesterol. Recently, there have been several studies that linked the drugs to an increased risk for new-onset diabetes.

One such study was the JUPITER study (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin; ClinicalTrials.gov number, NCT00239681). The study included 17,802 participants without diabetes that had LDL cholesterol levels below 3.4 mmol per liter and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher. It was revealed that the hazard ratio for newly diagnosed diabetes increased 25% in the Rosuvastatin group versus the placebo group. Despite this fact, the participants who had a low risk for cardiovascular events had important health improvements over the following period of approximately 2 years, with a hazard rate 44% lower than the placebo group for cardiovascular events. Rates for treated participants were lower for the key secondary outcomes as well: 54% for myocardial infarction, 48% for stroke, 46% for revascularization, and 20% for death from any cause. Other studies confirm this trend in diabetes risk increase; a meta-analysis of six statin trials that included 57,593 participants showed a 13% increase in relative risk, and another meta-analysis of 13 randomized statin trials with 91,140 participants showed an odds ratio of 1.09 for a new diagnosis of diabetes.

The meta-analysis suggests a strong correlation between the risk of diabetes and the use of statins, but also raises an important question: should the risk of diabetes and the risk of cardiovascular events be weighted in a similar manner? 255 patients were treated with statins for 4 years, which resulted in one additional case of diabetes. Given the fact that statins are used by approximately 24 million Americans, the population-attributable risk for diabetes is considerably large. The good news is that 5.4 cardiovascular events out of 255 patients were prevented, and this must be considered in context with the negative findings. (...)

(Anm: Meta-analysis of side effects of statins shows need for trial transparency. BMJ 2014;348:g2940 (Published 29 April 2014).)

(Anm: Crestor (rosuvastatin) (dailymed.nlm.nih.gov).)

- Vi anbefaler derfor sterkt å først prøve trening som terapi – det er gratis, gir overskudd og er uten bivirkninger!

Medikamenter som kan bremse treningseffekten
dn.no 22.4.2013
Kolesterolsenkende medisiner - eller trening? spør forsker Natale Rolim i ukens blogg.

- Vi anbefaler å prøve trening først som terapi. (...)

Men hva hvis trening ikke er nok? Noen ganger må pasienter med metabolsk syndrom behandles med medisiner i tillegg. Statiner er det hyppigst foreskrevne legemiddelet i verden, og bidrar til å senke kolesterolet. Denne måneden ble det publisert en artikkel i Journal of American College of Cardiology om effekten av statinbehandling versus trening i forhold til forbedring av hjertehelse, og resultatene er interessante. En gruppe overvektige utførte et veiledet treningsprogram bestående av 45 minutters gange eller lett jogging på tredemølle 5 dager i uken i 12 uker. En annen gruppe gjorde en kombinasjon av trening og medikamentell behandling med statiner. Statiner viste seg faktisk å bremse effekten av trening i denne siste gruppen.

Noe annet som er interessant, er at statiner i tillegg har vist seg å øke risikoen for muskelskade under trening. En studie av Sinzinger og kolleger (2004) fulgte 22 profesjonelle idrettsutøvere over 8 år. På grunn av familiehistorie med for høyt kolesterolnivå ble disse forsøksvis behandlet med statiner medikamentelt. Resultatene av analysene viste at bare 20 % av utøverne tålte denne behandlingen uten bivirkninger – blant annet var risikoen for muskelskader forhøyet.

Kolesterolsenkende medisiner hjelper mange pasienter, men det er altså verdt å tenke på at det ikke er uten bivirkninger. Vi anbefaler derfor sterkt å først prøve trening som terapi – det er gratis, gir overskudd og er uten bivirkninger! (...)

(Anm: Genes causing high cholesterol are less common than previously thought. (medicalnewstoday.com 4.4.2016).)

- Pasienter på kolesterolsenkende medisiner spiser mer

Pasienter på kolesterolsenkende medisiner spiser mer
nhi.no 1.5.2014
De siste tiårene har amerikanske statinbrukere økt kaloriinntaket, fettinntaket og KMI. Forskere er redde for at kostholdsgrep og livsstil blir vektlagt mindre, i takt med at populariteten av den kolesterolsenkende medisinen øker. (...)

Ingen økning blant ikke-brukerne
Statinbrukere hadde også et betydelig lavere fettinntak i 1999-2000, enn de hadde 10 år senere. (71.7 vs 81.2 gram per dag). Fettinntaket økte med 14.4 prosent blant statinbrukere, men forble det samme blant ikke-brukere. KMI - kroppsmasseindeks økte også mer blant statinbrukere.
Forfatterne konkluderer med at kalori- og fettinntak har økt blant statinbrukere over tid. Dette gjaldt ikke for de som ikke brukte statiner. Økningen i KMI var også raskere for statinbrukerne.

Bekymringsverdig
De nasjonale retningslinjene for behandling av høyt kolesterol i USA, har konsekvent anbefalt kostholdsgrep som nøkkelen til behandling av høyt kolesterol. Siden 2001 har disse retningslinjene også angitt at statiner er mer effektive enn andre medisiner mot høyt kolesterol. Bruk av statiner har økt kraftig (i USA) gjennom de siste 25 årene. Kaloriinntaket blant amerikanerne økte også kraftig, helt til det nådde et platå i 1999-2000. I denne perioden inntok statinbrukerne færre kalorier og mindre fett enn de som ikke brukte disse medisinene - som forventet hos personer som forsøker å få kontroll på kolesterolnivå og vekt, skriver forfatterne.

Ettersom en sentral del av behandling av høyt kolesterol innebærer å forebygge vektøkning, er det økte kaloriinntaket og den økte vekten bekymringsfull. (...)

- Med andre ord må 130 mennesker ta statiner ett år for å forhindre bare ett uønsket helseutkomme, og 500 mennesker må ta dem for å forhindre ett enkelt dødsfall. "Straks du kommer ned på svært lave risikonivåer er nytten svært liten," innrømmer Baigent

The Stats on Statins: Should Healthy Adults Over 50 Take Them? (Ståa for statiner: Bør friske voksne over 50 ta dem)
scientificamerican.com 22.5.2012
Selv om en metaanalyse for statiner foreslår at friske mennesker over 50 år bør ta kolesterolsenkende legemidler som forebyggende argumenterer enkelte forskere for at nytten ikke oppveier risikoen. (Although a meta-analysis of statins suggests that healthy people over 50 take cholesterol-lowering drugs as a preventative measure, some researchers argue the benefits may not outweigh the risks)

Everyone over 50 should take statins to lower their cholesterol, an editorial argued last week in The Lancet. The piece based its recommendation on a meta-analysis of 27 clinical trials published in the same issue that concluded statins significantly reduce the risk of heart attacks and other cardiovascular events in healthy people without posing substantial risks. Subsequent articles heralding the meta-analysis's findings were published in the Guardian, Forbes and the U.K. Telegraph. But based on the numbers, many experts still aren't convinced that the drugs' benefits outweigh their risks.

There's no question that statins save lives when they are prescribed to people with cardiovascular disease. But whether the drugs should also be given to healthy people who do not have high cholesterol or other cardiovascular risk factors has been a long-standing and controversial question. One large clinical trial known as JUPITER reported in 2008 that rosuvastatin (Crestor) lowers the risk of heart attacks and other events by 44 percent in healthy subjects but experts have since raised questions about its methodology in part because the trial was stopped early, which might have created the effect of overestimating the drug's benefits. The current meta-analysis was designed to help put the issue to rest. "Our aim was to bring together all the available evidence," explains co-author Colin Baigent, an epidemiologist at the University of Oxford in England.

After pooling the results of 27 trials involving 165,149 people, the meta-analysis reported that people are 21 percent less likely to suffer a serious vascular event such as a heart attack, stroke or bypass surgery after their cholesterol drops by the amount that might be expected after taking statins for a year than are similar people who do not take the pills. But such outcomes are rare in healthy individuals anyway, so the risk reduction actually translated to a small clinical benefit—reducing the overall risk from 4.04 percent to 3.27 percent per year, a difference of 0.77 percent.

Med andre ord må 130 mennesker ta statiner ett år for å forhindre bare ett uønsket helseutkomme, og 500 mennesker må ta dem for å forhindre ett enkelt dødsfall. "Straks du kommer ned på svært lave risikonivåer er nytten svært liten," innrømmer Baigent. (...) (In other words, approximately 130 people need to take statins for a year to prevent just one unwanted health outcome, and 500 people have to take them to prevent a single death. "Once you get down to very low levels of risk, the benefits are very small," Baigent admits.)

Experts also raise questions about the subjects included in the meta-analysis. Although the review was supposedly designed to assess the effects of statins in people at low risk of vascular disease, 60 percent of its participants in fact already had vascular disease. "Why combine people who have heart disease with people who don't? It's really misleading," says Kausik Ray, a cardiologist at Saint George's University of London. (...)

(Anm: Statins for all by the age of 50 years? Lancet 2012 (Early Online Publication, 17 May 2012).)

(Anm: The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. The Lancet, Early Online Publication, 17 May 2012.)

(Anm: Crestor (rosuvastatin) (dailymed.nlm.nih.gov).)

Guide: Se din gevinst ved kolesterolpiller
bt.dk 5.9.2012
Et nyt dansk studie viser, at langt de fleste danskere med et dagligt indtag af kolesterolmedicin kan forvente at forlænge deres liv med fire til seks eksta måneder. (...)

Spiser du dagligt kolesterolmedicin, kan du halvere din risiko for at dø af en hjerte-kar-sygdom. Det lyder af meget, men i virkeligheden betyder det oftest fire-seks måneder ekstra at leve i. Det viser et nyt dansk studie fra Aarhus Universitet, som er offentliggjort i ’European Journal of Preventive Cardiology’. (...)

Så lille er gevinsten ved pillerne
Så slemme er bivirkningerne ved kolesterolmedicin

bt.dk 7.5.2012
Al medicin virker på to måder. Den kan helbrede sygdom, og den kan give bivirkninger.

562.707 danskere tager dagligt en kolesterolpille. Så sent som i marts måned advarede de amerikanske sundhedsmyndigheder FDA om bivirkninger af pillerne som muskelsmerter og hukommelsesbesvær.

Desuden giver pillerne en minimalt øget risiko for diabetes, viser et nyt studie, der netop er offentliggjort i ’The New England Journal of Medicine’. Ifølge formanden for Praktiserende Lægers Organisation, Henrik Dibbern, har kolesterolpillerne mange uhensigtsmæssige bivirkninger.

- 1 ud af 100 vil opleve bivirkninger som muskelsmerter og -skader, der for især ældre mennesker kan hæmme dem i hverdagen, siger han.

Netdoktor.dk: Sådan føles det at have forhøjet kolestorol

Pillerne redder liv
Kolesterolpillerne redder mange liv, mener professor og overlæge på Herlev Universitetshospital Børge Nordestgaard. Hvis man oplever bivirkninger af medicinen, skal man droppe statinerne, men det er kun meget få, der oplever reelle bivirkninger.

- Jeg vil ikke negligere patienternes oplevelser med bivirkninger, men det er vigtigt at skelne mellem, om bivirkningerne skyldes medicinen, eller om folk tror, de skyldes medicinen. Store undersøgelser viser, at 15 pct. af alle medicinerede oplever bivirkninger. Men det gælder både dem, der får medicin, og dem, der får placebo-medicin som f.eks. kalktabletter, siger han. (...)

Vær aktiv og drop rygningen
BT har talt med flere danskere, der har droppet medicinen pga. de uønskede sideeffekter. Nogle af dem uden at konsultere deres læge først. Men lægen skal altid tages med på råd, før medicinen lægges på hylden, siger Hjerteforeningens forskningschef Gorm Jensen.

- Oplever man muskelproblemer, ømhed eller muskelbetændelse, skal man selvfølgelig ikke tage medicinen. Men i stedet være mere aktiv med motion, kost, vægttab og droppe rygning. (...)

Forskare ifrågasätter riktlinjer om statiner
dagensmedicin.se 18.5.2012
Statinbehandling kan göra nytta hos fler personer utan tidigare hjärt-kärlsjukdom. Det kommer forskare fram till i en ny analys i tidskriften Lancet.

Hos tidigare hjärtfriska individer begränsar i dag europeiska och amerikanska riktlinjer behandling med statinläkemedel till dem med minst 20 procent risk att drabbas av allvarliga hjärt-kärlhändelser inom en 10-årsperiod.

Men det ifrågasätts nu av forskare inom nätverket Cholesterol Treatment Trialists’ Collaboration. I en metaanalys drar de slutsatsen att nyttan med behandling är stor även hos individer med lägre risk.

Till grund för analysen ligger 27 studier med 175 000 deltagare och en uppföljningstid på runt fem år i median. (...)

(Anm: The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. The Lancet, Early Online Publication, 17 May 2012.)

Benefits of Widespread Statin Use Outweigh Risks: Study (Nytte av utbredt bruk av statiner oppveier risiko: studie)
news.yahoo.com 17.5.2012
THURSDAY, May 17 (HealthDay News) -- Statins -- commonly used cholesterol-lowering drugs -- can significantly lower the risk for heart disease in people with no history of vascular disease, according to a new study.

Researchers from the University of Oxford in England found the medication reduced the risk of major heart-related problems, such as hearts attacks and strokes, in men and women of all ages with heart disease -- as well as those with no previous history of the condition -- by about 20 percent. (...)

For their study, researchers examined 27 randomized trials involving 175,000 people. They investigated the effects of lowering LDL cholesterol with statins by grouping the patients into risk categories and comparing results. The researchers specifically explored whether statins were used and, if so, the intensity of the patients' therapy.

The study revealed that statins reduced the risk of serious vascular events by 21 percent in each of the five risk groups the researchers identified, including those at lowest risk for vascular disease.

The study was published online Wednesday in The Lancet. (...)

(Anm: The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. The Lancet, Early Online Publication, 17 May 2012.)

- Gjør statiner det vanskelig å trene?

The Nuclear Orphan Receptor NR4A1 is Involved in the Apoptotic Pathway Induced by LPS and Simvastatin in RAW 264.7 Macrophages.
Immune Netw. 2014 Apr;14(2):116-22.
Epub 2014 Apr 21.
Abstract Macrophage death plays a role in several physiological and inflammatory pathologies such as sepsis and arthritis. In our previous work, we showed that simvastatin triggers cell death in LPS-activated RAW 264.7 mouse macrophage cells through both caspase-dependent and independent apoptotic pathways. Here, we show that the nuclear orphan receptor NR4A1 is involved in a caspase-independent apoptotic process induced by LPS and simvastatin. Simvastatin-induced NR4A1 expression in RAW 264.7 macrophages and ectopic expression of a dominant-negative mutant form of NR4A1 effectively suppressed both DNA fragmentation and the disruption of mitochondrial membrane potential (MMP) during LPS- and simvastatin-induced apoptosis. Furthermore, apoptosis was accompanied by Bcl-2-associated X protein (Bax) translocation to the mitochondria. Our findings suggest that NR4A1 expression and mitochondrial translocation of Bax are related to simvastatin-induced apoptosis in LPS-activated RAW 264.7 macrophages. (...)

(Anm: Statins and brain dysfunction in intensive care. Severe critical illness, the leading medical causes of which are sepsis and acute respiratory distress syndrome, is often complicated by acute brain dysfunction, which is mainly characterised by changes in consciousness (ranging from delirium to coma) and various electrophysiological changes. Lancet Respir Med. 2016 Jan 28. pii: S2213-2600(16)00028-X.)

(Anm: Delirium is associated with 5-fold increased mortality in acute cardiac patients. (medicalnewstoday.com 16.3.2017).)

(Anm: MITOCHONDRIAL FUNCTION IN SEPSIS. Shock. 2016 Mar;45(3):271-281.)

(Anm: Cause of immune system paralysis in sepsis identified. New insights into how the immune system can malfunction during sepsis are reported in a paper published online in Nature Immunology. The study demonstrates a new approach for reversing the paralysis of the immune system that characterizes the late stages of sepsis. (…) The team was also able to restore metabolic activity and responsiveness in white blood cells from patients with fungal sepsis by treating them with interferon-γ - a factor released by normal white blood cells responding in a healthy way. (medicalnewstoday.com 7.3.2016).)

Simvastatin impairs ADP-stimulated respiration and increases mitochondrial oxidative stress in primary human skeletal myotubes (Simvastatin svekker ADP-stimulert respirasjon og øker mitokondrielt oksydativt stress i primære menneskelige skjelett myotuber)
Free Radic Biol Med. 2012 Jan 1;52(1):198-207. Epub 2011 Oct 25.
Abstract Statins, the widely prescribed cholesterol-lowering drugs for the treatment of cardiovascular disease, cause adverse skeletal muscle side effects ranging from fatigue to fatal rhabdomyolysis. The purpose of this study was to determine the effects of simvastatin on mitochondrial respiration, oxidative stress, and cell death in differentiated primary human skeletal muscle cells (i.e., myotubes). Simvastatin induced a dose-dependent decrease in viability of proliferating and differentiating primary human muscle precursor cells, and a similar dose-dependent effect was noted in differentiated myoblasts and myotubes. Additionally, there were decreases in myotube number and size following 48 h of simvastatin treatment (5 μM). In permeabilized myotubes, maximal ADP-stimulated oxygen consumption, supported by palmitoylcarnitine+malate (PCM, complex I and II substrates) and glutamate+malate (GM, complex I substrates), was 32-37% lower (P<0.05) in simvastatin-treated (5 μM) vs control myotubes, providing evidence of impaired respiration at complex I. Mitochondrial superoxide and hydrogen peroxide generation were significantly greater in the simvastatin-treated human skeletal myotube cultures compared to control. In addition, simvastatin markedly increased protein levels of Bax (proapoptotic, +53%) and Bcl-2 (antiapoptotic, +100%, P<0.05), mitochondrial PTP opening (+44%, P<0.05), and TUNEL-positive nuclei in human skeletal myotubes, demonstrating up-regulation of mitochondrial-mediated myonuclear apoptotic mechanisms. These data demonstrate that simvastatin induces myotube atrophy and cell loss associated with impaired ADP-stimulated maximal mitochondrial respiratory capacity, mitochondrial oxidative stress, and apoptosis in primary human skeletal myotubes, suggesting that mitochondrial dysfunction may underlie human statin-induced myopathy. (...)

(Anm: Simvastatin enhances human osteoblast proliferation involved in mitochondrial energy generation. Eur J Pharmacol. 2013 Jun 11 (mintankesmie.no).)

(Anm: Muskelsykdom (myopati) (nevro.legehandboka.no).)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

(Anm: Linking telomere loss and mitochondrial dysfunction in chronic disease. (…) Drawing a mechanistic connection between telomere function and mitochondria biology will provide a broader perspective for understanding the pathophysiology of diseases and their relation to the aging process, and may provide opportunities for new possible treatments. Front Biosci (Landmark Ed). 2017 Jan 1;22:117-127.)

(Anm: Extreme short and long telomeres linked to increased cancer risk (news-medical.net 5.4.2017).)

(Anm: Scientists discover master regulator of cellular aging. (…) "Telomeres represent the clock of a cell," said TSRI Associate Professor Eros Lazzerini Denchi, corresponding author of the new study, published online in the journal Science. "You are born with telomeres of a certain length, and every time a cell divides, it loses a little bit of the telomere. Once the telomere is too short, the cell cannot divide anymore." (medicalnewstoday.com 13.1.2017).)

(Anm: Betennelser endrer mitokondrier til giftige fabrikker. Å lære hvordan å kontrollere betennelser kan ha store implikasjoner for behandlingen av mange sykdommer. Banebrytende forskning oppdager hvordan makrofager endrer mitokondriene til giftige kjemisk-produserende betennelsespromotører. (Inflammation turns mitochondria into toxic factories. Learning how to control inflammation could have huge implications for the treatment of many diseases. Breaking research discovers how macrophages turn mitochondria into toxic chemical-producing inflammation-promoters.) (medicalnewstoday.com 25.9.2016).)

(Anm: Research may show new ways to repress inflammation at outset. (…) Professor Alexander Weber of the Interfaculty Institute of Cell Biology says the enzyme - Bruton's tyrosine kinase or BTK - is switched on when an inflammation occurs in the body, playing a key role in the inflammation's subsequent development. (medicinenet.com 21.2.2017).)

(Anm: Ørsmå mitokondrier spiller en svært stor rolle mht. menneskets evolusjon og sykdom (Tiny mitochondria play outsized role in human evolution and disease.) (medicalnewstoday.com 25.9.2015).)

(Anm: Understanding mitochondrial complex I assembly in health and disease. Biochim Biophys Acta. 2012 Jun;1817(6):851-62. Epub 2011 Sep 2.)

(Anm: Selective inhibition of deactivated mitochondrial complex I by biguanides. Biochemistry. 2015 Feb 26. [Epub ahead of print].)

Do Statins Make It Tough to Exercise? (Gjør statiner det vanskelig å trene?)
well.blogs.nytimes.com 14.3.2012
Can a statin ruin your workout?
For years, physicians and scientists have been aware that statins, the most widely prescribed drugs in the world, can cause muscle aches and fatigue in some patients. What many people don’t know is that these side effects are especially pronounced in people who exercise. (...)

To learn more about the effect statins have on exercising muscles, scientists in Strasbourg, France, recently gave the cholesterol-lowering drug Lipitor to a group of rats for two weeks, while a separate control group was not medicated. Some of the rats from both groups ran on little treadmills until they were exhausted.

It was immediately obvious that the medicated animals couldn’t run as far. They became exhausted much earlier than the rats that had not been given statins.

The differences were even more striking at a cellular level. When the scientists studied muscle tissues, they found that oxidative stress, a measure of possible cell damage, was increased by 60 percent in sedentary animals receiving statins, compared with the unmedicated control group.

The effect was magnified in the runners, whose cells showed 226 percent more oxidative stress than exercising animals that had not been given statins. (...)

Statins’ safety has come under considerable scrutiny in recent weeks. Last month, the Food and Drug Administration added safety alerts to prescribing information for statins, warning of risks for memory loss and diabetes, as well as muscle pain. (Read more about those concerns here.) (...)

(Anm: Simvastatin impairs exercise training adaptations. J Am Coll Cardiol. 2013 Aug 20;62(8):709-14. Epub 2013 Apr 10.)

Advarer mot kolesterolmedisiner
vg.no 5.3.2012
Mulige bivirkninger: Hukommelsestap, diabetes og muskelsmerter (...)

I 2011 fikk 500000 nordmenn kolesteroldempende medisiner som inneholder statiner. (...)

- Statiner forårsaker utmattelse

Derfor bliver du sløv:
Kolesterol-medicinen gør dig træt

b.dk 3.7.2012
Ny forskning viser, at kolesterolsænkende piller kan give dig træthed og nedsat energi. Her ser vi nærmere på undersøgelsen og giver dig råd til, hvad du kan gøre.

Manglende energi, træthed og en mathedsfølelse i hele kroppen. Det er ifølge en ny undersøgelse helt almindelige bivirkninger for de næsten 600.000 danskere, der hvert år indløser en recept på kolesterolsænkende medicin. (...)

Slapp og sliten av statiner?
nhi.no 14.6.2012
Forskere anslår at 15 prosent av de som bruker statiner, opplever mer slitenhet generelt eller i forbindelse med trening, på grunn av medisinene.

Ifølge en studie som ble forhåndspublisert på nett i Archives of Internal Medicine i juni 20121, kan bruk av kolesterolsenkende statiner tappe deg for energi.
Forskerne mener at den potensielle bivirkningen særlig rammer kvinner.

Særlig sterk effekt hos kvinner
Forfatterne brukte data fra en tidligerer studie, der mer enn 1000 menn og kvinner ble tilfeldig utvalgt til å bruke enten statinet simvastatin 20 mg (Simvastatin, Zocor) eller statinet pravastatin 40 mg (Pravastatin, Pravachol), eller placebo i seks måneder.

Funnene antyder at ca. 15 prosent av statinbrukerne følte seg mer slitne generelt eller i forbindelse med trening. Begge statin-typene ga denne effekten sammenlignet med placebo-gruppen, og den var særlig sterk hos kvinner.

Forskerne anslår at fire av ti kvinner som bruker simvastatin eller pravastatin, får mindre energi eller føler seg mer trette når de trener, på grunn av medisinen. Disse funnene kan være nyttig å kjenne til, ettersom energi og funksjonsnivå er viktig for å føle seg bra. Forskerne anbefaler at det bør gjøres langtidsstudier, hvis statiner skal anbefales til bruk av yngre personer. Det er også viktig at leger er oppmerksomme på tilbakemeldinger fra pasienter som bruker statiner, og som oppgir anstrengelsesutløst utmattelse eller redusert energinivå. (...)

(Anm: Do statins drain your energy? (reuters.com 11.6.2012).)

(Anm: Simvastatin impairs exercise training adaptations. J Am Coll Cardiol. 2013 Aug 20;62(8):709-14. Epub 2013 Apr 10.)

(Anm: Effects of Statins on Energy and Fatigue With Exertion: Results From a Randomized Controlled Trial. Arch Intern Med. 2012;():1-2.)

Statins shown to cause fatigue (Statiner vist å forårsake utmattelse)
worldpharmanews.com 12.6.2012
In a study of more than 1,000 adults, researchers at the University of California, San Diego, found that individuals taking cholesterol-lowering statin drugs are more likely than non-users to experience decreased energy, fatigue upon exertion, or both. The researchers suggest that these findings should be taken into account by doctors when weighing risk versus benefit in prescribing statins.

Statin drugs are among the best selling and most widely used prescription drugs on the market. Recently, increasing attention has focused on statins' side effects, particularly their effect on exercise. While some patients have reported fatigue or exercise intolerance when placed on statins, randomized trials had not previously addressed occurrence of fatigue-with-exertion or impaired energy in patients on statins relative to placebo.

In the June 11 issue of Archives of Internal Medicine Beatrice Golomb, MD, PhD, associate professor of medicine at UC San Diego School of Medicine, and colleagues present randomized trial data which show that these side effects were significantly greater in persons placed on statins than those on a placebo. (...)

(Anm: Effects of Statins on Energy and Fatigue With Exertion: Results From a Randomized Controlled Trial. Arch Intern Med. 2012;():1-2.)

(Anm: Kronisk tretthetssyndrom/Myalgisk encefalopati (CFS/ME). (mintankesmie.no).)

(Anm: Chronic Fatigue Syndrome Causes and Treatment (webmd.com 1.6.2016).)

(Anm: Nøkkelen til kronisk utmattelsessyndrom sitter i tarmen, ikke hodet. (Key to chronic fatigue syndrome is in your gut, not head.) (mediarelations.cornell.edu 27.6.2016).)

(Anm: Fluoksetin (Prozac; SSRI) og mitokondriene: En gjennomgang av de toksikologiske aspekter. (- Fluoksetin induserer også bivirkninger, som for eksempel angst, seksuell dysfunksjon, søvnforstyrrelser, og gastrointestinale svekkelser. (...) På den annen side har inntak av fluoxetin blitt assosiert med økt risiko for kreft. Likevel forblir data motstridende og ingen konklusjoner er trukket.) (Fluoxetine and the mitochondria: A review of the toxicological aspects. (Fluoksetin og mitokondriene: En gjennomgang av de toksikologiske aspekter. (...) On the other hand, fluoxetine intake has been associated with increased cancer risk.) Toxicol Lett. 2016 Jul 5. pii: S0378-4274(16)32264-0.)

(Anm: SSRI-er (lykkepiller) forårsaker en varig serotonerg ubalanse grunnet legemidlenes skadelige endringer mht. serotonin og andre nevrotransmittere, mitokondriell dysfunksjon, avkortet levetid, plutselige dødsfall etc. (- SSRI-er øker nivået av serotonin i deler av hjernen med opptil 700 % (eller mer?), samt reduserer serotonin i blod med opptil 93 %.) (mintankesmie.no).)

(Anm: Effekten av psykostimulerende legemidler på blod-hjerne barrierens funksjon og nevroinflammasjon. (The effects of psychostimulant drugs on blood brain barrier function and neuroinflammation) (Front. Pharmacol. 2012;3:121 (Published online: 29 June 2012).)

(Anm: - Pfizers Zyvoxid (Zyvox) og antidepressiva kan være en dødelig kombinasjon. (- Det antas at når linezolid gis til pasienter, som behandles med serotonerge psykofarmaka, kan forhøyede nivåer av serotonin bygge seg opp i hjernen og forårsake toksisitet (giftighet). Dette er referert til som Serotonin syndrom - tegn og symptomer inkluderer mentale endringer (forvirring, hyperaktivitet, minneproblemer), muskelrykninger, overdreven svetting, skjelving eller risting, diaré, problemer med koordinasjon og / eller feber.) (fda.gov 21.10.2011).)

(Anm: Infektioner er forbundet med selvmord. Svære infektioner er forbundet med øget risiko for selvmord, viser ny dansk undersøgelse. (…) Reaktioner i hjernen kan være en del af forklaringen på forbindelsen mellem selvmord og infektion, konkluderer forskerne. (videnskab.dk 10.8.2016).)

(Anm: Insight into cancer cells' abnormal behavior. Scientists at Lancaster University have shed light on the metabolic switch observed in abnormal cells like cancer. The change in cellular energy metabolism is a hallmark of many diseases as cells change from healthy to abnormal metabolic states. (medicalexpress.com 4.8.2016).)

(Anm: Denne studiegjennomgangen tar for seg de baner (veier) som kan forklare mitokondrielle dysfunksjoner ved ME / CFS. (This paper reviews the pathways that may explain mitochondrial dysfunctions in ME/cfs (Denne artikkelen tar for seg de baner (veier) som kan forklare mitokondrielle dysfunksjoner ved ME / CFS). Metab Brain Dis. 2014 Mar;29(1):19-36. Epub 2013 Sep 10.)

(Anm: Simvastatin impairs exercise training adaptations. J Am Coll Cardiol. 2013 Aug 20;62(8):709-14. Epub 2013 Apr 10.)

- Behandling med statiner kan avsluttes når sykdommen er uhelbredelig, rapporterer studie

Statin Use Can Stop When Illness Is Terminal, Study Reports (Behandling med statiner kan avsluttes når sykdommen er uhelbredelig, rapporterer studie)
JAMA 2014 (May 30, 2014)
Patients whose life expectancy is less than a year can safely stop using statins, a new study reports.

Discontinuing statin use in patients with late-stage cancer or other terminal illnesses isn’t harmful and may help improve patients’ quality of life, according to new research.

Data presented today at the American Society for Clinical Oncology’s annual meeting in Chicago show that ending statin use in patients with advanced diseases appears to offer several benefits. The study’s lead author, Jean Kutner, MD, MSPH, of the University of Colorado Cancer Center in Aurora, called research on when to stop preventive medications “a new line of investigation. (...)

(Anm: Patients with terminal illnesses benefit from stopping statins (medicalnewstoday.com 3.6.2014).)

- Legemidlers mitokondrielle giftighet

[Mitochondrial toxicity of drugs].
Med Monatsschr Pharm. 2012 Dec;35(12):445-56.
Abstract Considering the complexity of mitochondria, it is not surprising that the pathogenesis of adverse drug events often develop on drug-induced mitochondrial injury. Drug induced mitochondrial toxicity can occur through several mechanisms, such as depletion of mtDNA (e.g. NRTI), inhibition of fatty acid beta-oxidation (e.g. valproic acid), opening of the mitochondrial permeability transition pore (e.g. anthracyclines), formation of mitochondrial oxidative stress and depletion of mitochondrial glutathione pool (e.g. acetaminophen), uncoupling of electron transport from ATP synthesis (e.g. tamoxifen) and inhibition of mitochondrial electron transport chain complexes (e.g. simvastatin). This review focuses on the mitochondrial toxicity of drugs in general and explains the practical relevance of these adverse drug events according to specific drugs (metformin, statins, acetaminophen, valproic acid). Furthermore the significance of mitotropic micronutrients such as coenzyme Q10, L-carnitine and glutathione in the prevention and management ofdrug-induced mitochondrial injury is discussed. (...)

(Anm: Simvastatin impairs exercise training adaptations. J Am Coll Cardiol. 2013 Aug 20;62(8):709-14. Epub 2013 Apr 10.)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

(Anm: Linking telomere loss and mitochondrial dysfunction in chronic disease. (…) Drawing a mechanistic connection between telomere function and mitochondria biology will provide a broader perspective for understanding the pathophysiology of diseases and their relation to the aging process, and may provide opportunities for new possible treatments. Front Biosci (Landmark Ed). 2017 Jan 1;22:117-127.)

(Anm: Extreme short and long telomeres linked to increased cancer risk (news-medical.net 5.4.2017).)

(Anm: Scientists discover master regulator of cellular aging. (…) "Telomeres represent the clock of a cell," said TSRI Associate Professor Eros Lazzerini Denchi, corresponding author of the new study, published online in the journal Science. "You are born with telomeres of a certain length, and every time a cell divides, it loses a little bit of the telomere. Once the telomere is too short, the cell cannot divide anymore." (medicalnewstoday.com 13.1.2017).)

(Anm: Betennelser endrer mitokondrier til giftige fabrikker. Å lære hvordan å kontrollere betennelser kan ha store implikasjoner for behandlingen av mange sykdommer. Banebrytende forskning oppdager hvordan makrofager endrer mitokondriene til giftige kjemisk-produserende betennelsespromotører. (Inflammation turns mitochondria into toxic factories. Learning how to control inflammation could have huge implications for the treatment of many diseases. Breaking research discovers how macrophages turn mitochondria into toxic chemical-producing inflammation-promoters.) (medicalnewstoday.com 25.9.2016).)

(Anm: Research may show new ways to repress inflammation at outset. (…) Professor Alexander Weber of the Interfaculty Institute of Cell Biology says the enzyme - Bruton's tyrosine kinase or BTK - is switched on when an inflammation occurs in the body, playing a key role in the inflammation's subsequent development. (medicinenet.com 21.2.2017).)

(Anm: Ørsmå mitokondrier spiller en svært stor rolle mht. menneskets evolusjon og sykdom (Tiny mitochondria play outsized role in human evolution and disease.) (medicalnewstoday.com 25.9.2015).)

(Anm: Is Coenzyme Q10 Effective in Statin Myopathy? Atherosclerosis 2015 Feb. - During 8 weeks of treatment, CoQ10 had no effect on muscle symptoms. (NEJM 2017 (January 27, 2015).)

(Anm: Coenzyme Q10 protects against statin-induced myotoxicity in zebrafish larvae (Danio rerio). Environ Toxicol Pharmacol. 2017 Apr 1;52:150-160.)

- Effekten av psykostimulerende legemidler på blod-hjerne barrierens (BBBs) funksjon og nevroinflammasjon.

(Anm: Effekten av psykostimulerende legemidler på blod-hjerne barrierens (BBBs) funksjon og nevroinflammasjon (The effects of psychostimulant drugs on blood brain barrier function and neuroinflammation) Front. Pharmacol. 2012;3:121 (Published online: 29 June 2012.)

(Anm: Inflammation in Middle Age May Be Tied to Brain Shrinkage Decades Later. MINNEAPOLIS, Minn -- November 1, 2017 -- People who have biomarkers tied to inflammation in their blood in their 40s and 50s may have more brain shrinkage decades later than people without the biomarkers, according to a study published in the November 1, 2017, online issue of Neurology. The brain cell loss was found especially in areas of the brain that are affected by Alzheimer’s disease. (dgnews.docguide.com 1.11.2017).)

(Anm: Alzheimers sykdom: Kan en lekk blod-hjerne barrieren (BBB) være involvert? (Alzheimer's disease: Could a leaky blood-brain barrier be involved? (…) "Blood-brain barrier leakage means that the brain has lost its protective means, the stability of brain cells is disrupted and the environment in which nerve cells interact becomes ill-conditioned. These mechanisms could eventually lead to dysfunction in the brain." The blood-brain barrier (BBB) separates the brain from circulating blood to keep brain tissue healthy. It is a collection of specialized cells and cellular components that line the walls of blood vessels in the brain and the rest of the central nervous system. The BBB controls the delivery of important nutrients, blocks substances that can harm the brain, and removes waste from the brain.) (medicalnewstoday.com 31.5.2016).)

(Anm: A journey into the brain: insight into how bacterial pathogens cross blood–brain barriers. The blood–brain barrier, which is one of the tightest barriers in the body, protects the brain from insults, such as infections. Indeed, only a few of the numerous blood-borne bacteria can cross the blood–brain barrier to cause meningitis. In this Review, we focus on invasive extracellular pathogens, such as Neisseria meningitidis, Streptococcus pneumoniae, group B Streptococcus and Escherichia coli, to review the obstacles that bacteria have to overcome in order to invade the meninges from the bloodstream, and the specific skills they have developed to bypass the blood–brain barrier. The medical importance of understanding how these barriers can be circumvented is underlined by the fact that we need to improve drug delivery into the brain. Nature Reviews Microbiology 2017 (Published online 16 January 2017).)

(Anm: Serum-borne bioactivity caused by pulmonary multiwalled carbon nanotubes induces neuroinflammation via blood–brain barrier impairment. Significance. Inhaled particulates, such as multiwalled carbon nanotubes, can induce neuroinflammatory outcomes. The present study shows that acute neuroinflammation is dependent on the impairment of blood-brain barrier function. Pharmacologic restoration of blood-brain barrier integrity prevented the neuroinflammatory responses to pulmonary multiwalled carbon nanotube exposure. Circulating factors, including possibly thrombospondin-1, recapitulate inflammatory responses in cultured cerebrovascular endothelial cells, suggesting a mechanism for indirect systemic effects of inhaled nanoparticles.   PNAS (Proceedings of the National Academy of Sciences) 2017;114(10):2705–2710.)

(Anm: Leaky blood-brain barrier linked to Alzheimer's disease. Researchers using contrast-enhanced MRI have identified leakages in the blood-brain barrier (BBB) of people with early Alzheimer's disease (AD), according to a new study published online in the journal Radiology. The results suggest that increased BBB permeability may represent a key mechanism in the early stages of the disease.  (medicalxpress.com 31.5.2016).)

(Anm: nevrotoksisk; Forårsake skade eller toksisitet av sentrale eller perifere nervesystemet (wikbio.com.no).)

(Anm: Disruption of brain-blood barrier might influence progression of Alzheimer's (medicalnewstoday.com 30.9.2015).)

(Anm: Brain's immune cells key to maintaining blood-brain barrier. New research shows that the cells responsible for protecting the brain from infection and inflammation are also responsible for repairing the system of defenses that separates the brain from the rest of the body. These findings have significant clinical implications because certain cardiovascular drugs could possibly impede the brain's ability to repair itself after a stroke or other injury. (medicalnewstoday.com 12.1.2016).)

(Anm: Neuroinflammation after intracerebral hemorrhage Front. Cell. Neurosci. 2014 (20 November 2014).)

- Statinbruk knyttet til raskere oppbygging av plakk

ADA: Statin Use Tied to Faster Plaque Buildup (Statinbruk knyttet til raskere oppbygging av plakk)
medpagetoday.com 11.6.2012
(...) Participants who were frequent statin users had significantly more coronary plaque advancement than those who were less frequent users (P<0.001), according to Aramesh Saremi, MD, from the Phoenix VA Health Care System in Arizona, and colleagues.

The results remained the same even after adjusting for age, duration of diabetes, hypertension, cardiovascular events, baseline coronary artery calcium, race and ethnicity, blood pressure, total cholesterol/high density lipoprotein cholesterol (HDL-C), and body mass index, Saremi's team reported here at the annual meeting of the American Diabetes Association.

But it would be a "horrible mistake" to infer that strict compliance with statin use is somehow causally associated with progression of atherosclerosis, warned Cam Patterson, MD, from the Center for Heart and Vascular Care at the University of North Carolina at Chapel Hill. Patterson, who was not involved in this study, added that such a conclusion is definitively a false one. (...)

- Statiner linket til katarakt

Statins Linked to Cataracts (Statiner linket til katarakt)
medpagetoday.com 19.9.2013
Statiner fjerner kolesterol fra blod, men de gjør det på bekostning av synet antyder en ny "score-matched study". (Statins clear cholesterol from the blood but they may do so at the risk of obstructing vision, a new propensity score-matched study suggested.)

In the primary analysis of 6,972 matched pairs of statin users and nonusers, those taking the cholesterol-lowering medication had a 9% increased risk of developing cataracts (95% CI 1.02-1.17), reported Ishak Mansi, MD, of the VA North Texas Health System at the University of Texas Southwestern in Dallas, and colleagues.

In a secondary subgroup analysis of 33,513 patients (6,113 on statins) who had no comorbidity, based on the Charlson comorbidity index, the use of statins remained significantly associated with cataracts (OR 1.27, 95% CI 1.15-1.40), according to the study published online in JAMA Ophthalmology. (...)

(Anm: Øyesykdommer (øyner er sjelens vindu). (mintankesmie.no).)

(Anm: Very low levels of bad cholesterol well-tolerated in heart disease patients. Heart disease patients taking PCSK9 inhibitors to achieve very low levels of cholesterol do not experience an increase in adverse events, including memory impairment or nervous system disorders, but may have an increased risk of cataracts, according to a study in the Journal of the American College of Cardiology. (…) Analyses did show an increased incidence of cataracts in patients with LDL less than 25 versus greater than 25. This could be a chance finding, or it could be because reducing cholesterol accelerates underlying aging-related changes, contributing to cataracts. (medicalnewstoday.com 31.1.2017).)

(Anm: ”Tveksam nytta av nya kolesterol­sänkare”. Varför avbröts det kolesterolsänkande experimentet Fourier i förtid? frågar forskaren Uffe Ravnskov. Professor Peter M Nilsson säger i Dagens Medicin nr 12/17 att det viktigaste beskedet från det senaste kolesterolsänkande experimentet Fourier är att det ”en gång för alla begraver alla tvivel om LDL-kolesterolets skadliga roll i uppkomsten av hjärt-kärlsjukdom.” Men hur förklarar han att det var 444 som dog i behandlingsgruppen men endast 426 i kontrollgruppen? Och hur förklarar han att det var fler som dog av en hjärt-kärlsjukdom i behandlingsgruppen? (dagensmedicin.se 29.3.2017).)

(Anm: Emotsedd studie öppnar för PCSK9-hämmare. En absolut riskminskning för nya hjärt-kärlhändelser med 1,5 procentenheter efter två år. Det blev resultatet när patienter med etablerad aterosklerotisk sjukdom fick tilläggsbehandling med det nya kolesterolsänkande läkemedlet Repatha (evolocumab). (dagensmedicin.se 17.3.2017).)

(Anm: Etterlengtet studie på nye kolesterolsenkende overbeviser ikke helt. Kardiologene lar seg ikke helt overbevise av resultatene av den første større studien på nye kolesterolsenkende legemidler. En absolutt risikoreduksjon for nye hjerte- og karhendelser med 1,5 prosentpoeng etter to år. Og ingen reduksjon i dødelighet. Store forventninger. Det er resultater av FOURIER-studien, som har sett på effekten av et nytt kolesterolsenkende legemiddel, PCSK9-hemmeren evolocumab (Rephata).  (…) Den kolesterolsenkende effekten av disse legemidlene er uvanlig stor. Samtidig er de svært dyre. Derfor er det knyttet strenge restriksjoner til bruken av disse i Norge, hvor vi har to godkjente legemidler i denne klassen. (dagensmedisin.no 31.3.2017).)

(Anm: Large eyes come at a high cost. (…)"Animals with large and well-developed eyes, necessary for their survival, pay a high price for them. As all animals have a strictly limited energy budget, a major investment in the visual system only occurs at a cost to other organ systems", says Eric Warrant, researcher in Functional Zoology at Lund University.  (mmedicalnewstoday.com 14.9.2015).)

(Anm: Association of Statin Use With Cataracts: A Propensity Score–Matched Analysis. JAMA Ophthalmol. 2013 (September 19, 2013).)

Statin Use Is Associated with Excess Risk for Cataracts
NEJM 2013 (September 24, 2013)
One more reason to carefully weigh the risks and benefits of statins, especially for primary prevention

Observational studies of risk for cataracts with statin use have yielded conflicting results. Using data collected between 2003 and 2010 in the clinical and administrative database of a military healthcare system in Texas, researchers conducted a retrospective cohort analysis that involved 6972 pairs of statin users and nonusers. Statin users were defined as patients who received at least 90-day supplies of statin medications at baseline (mean duration of statin use, ≈5 years). Participant pairs were matched for 44 clinical, medication, and healthcare variables associated with either likelihood of receiving a statin or risk for developing cataracts.

During up to 6 years of follow-up, risk for developing cataracts was 35.5% among statin users and 33.5% among nonusers — a significant difference. An increased risk associated with statin use also was noted in a secondary analysis restricted to patients with few comorbidities.

COMMENT
The clinical trial needed to confirm these results is unlikely to be done. The study design and analyses here are sufficiently robust to support caution in prescribing statins to patients who might benefit only marginally, particularly patients at low risk for cardiovascular disease. (...)

(Anm: Association of Statin Use With Cataracts: A Propensity Score–Matched Analysis. JAMA Ophthalmol. 2013 (September 19, 2013).)

- Statin-associated lower urinary tract symptoms: data mining of the public version of the FDA adverse event reporting system, FAERS

Statin-associated lower urinary tract symptoms: data mining of the public version of the FDA adverse event reporting system, FAERS
Int J Clin Pharmacol Ther. 2014 Jan 29. [Epub ahead of print]
Objective: To examine the association between statin use and the risk of lower urinary tract symptoms (LUTS) in reports submitted to the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) between 2004 and 2011. Methods: Relevant reports in the FAERS were identified and analyzed. The reporting odds ratio (ROR) was used to detect spontaneous report signals, calculated using the case/non-case method. Cases were identified by the presence of reports of an adverse drug reaction (ADR) in which statins were the suspected drug. Non-cases were all the reports of the same reactions induced by drugs other than statins. The reporting odds ratio (ROR) and 95% confidential interval (CI) was calculated as a measure of disproportionality. Results: A total of 44,959,104 drug-reaction pairs was found in 2,681,739 reports. Significant RORs were found for both voiding (ROR; 1.16, 95% CI; 1.10 - 1.23) and storage symptoms (ROR; 1.25, 95% CI; 1.20 - 1.30). Analysis of individual statins showed that rosuvastatin, atorvastatin, and lovastatin had significant disproportionality for voiding symptoms, while simvastatin, rosuvastatin, pravastatin, atorvastatin, pitavastatin, and lovastatin had significant disproportionality for storage symptoms. Of the four voiding symptoms, significant RORs were found for urine flow decrease and dysuria. Of the four storage symptoms, significant RORs were found for pollakiuria and nocturia. No fundamental differences in disproportionality were observed between genders. Conclusions: Analysis of the FAERS database showed small but reliable signals for LUTS in statin users. The mechanism responsible for these reactions is unknown. However, these adverse events should be monitored closely. (...)

(Anm: Crestor (rosuvastatin) (dailymed.nlm.nih.gov).)

- Statiner kan forhindre muskelreperasjon (- Muskelskader fra statiner kan gjemme seg bak normale laboratorietester)

Statins can weaken muscles and joints: Cholesterol drug raises risk of problems by up to 20 per cent (Statiner kan svekke muskler og ledd: kolesterollegemiddel øker risikoen for problemer med opptil 20 prosent)
dailymail.co.uk 3.6.2013
• Statins are the most widely prescribed drugs in Britain
• However, many complain of muscle pain and joint weakness

Taking statins makes you more likely to be diagnosed with muscle pain, joint diseases and injuries, researchers have warned.

They found a 20 per cent increased risk of muscle problems in those on the cholesterol-lowering drugs compared with those not taking them.
The US team says the risk may be relatively small but it is important because millions of older patients with heart conditions take statins and their use may eventually widen to include healthy younger people.

Statins are the most widely prescribed drugs in Britain. The number of patients taking them is estimated at 5million to 8million.
But there have been persistent complaints about side effects such as muscle pain and weakness. (...)

(Anm: Statins and Musculoskeletal Conditions, Arthropathies, and Injuries JAMA Intern Med. 2013;():1-9 (June 3, 2013).)

Zocor (simvastatin): increased risk of muscle injury with high doses (Zocor (simvastatin): økt risiko for muskelskader ved høye doser)
fda.gov 19.3.2010
Simvastatin is sold as a single-ingredient generic medication and as the brand-name, Zocor. It is also sold in combination with ezetimibe as Vytorin; and niacin as Simcor.

[Posted 03/19/2010] FDA notified healthcare professionals and patients that, based on review of data from a large clinical trial and other sources, there is an increased risk of muscle injury in patients taking the highest approved dose of the cholesterol-lowering medication, Zocor (simvastatin) 80 mg, compared to patients taking lower doses of simvastatin and possibly other drugs in the "statin" class. FDA is also reviewing data from other clinical trials, observational studies, adverse event reports, and data on prescription use of simvastatin to better understand the relationship between high-dose simvastatin use and muscle injury. (...)

(Anm: Niacin for cholesterol now linked to death risk, dangerous side effects and no benefits (medicalnewstoday.com 19.7.2014).)

Statins can Damage Muscles (Statiner kan skade muskler)
ivanhoe.com 10.7.2009
(Ivanhoe Newswire) -- Because of their importance in reducing the risk of cardiovascular disease, statins are one of the most widely prescribed medications in the world. One well-known side effect of taking statins is muscle weakness and pain. Researchers are now finding that structural muscle damage may be present in patients who have statin-associated muscle complaints. In some cases, muscle biopsies have shown underlying structural injury to the muscles even in patients who had discontinued medication before the biopsies were taken.

A new study by researchers from the University of Bern, Switzerland, and the Tufts-New England Medical Center in Boston, Massachusetts, looked at muscle biopsies from 83 patients, 20 of whom had never taken statins. They found significant muscle injury in patients who had taken statins, including several who had discontinued medication before the biopsy. (...)

(Anm: Association between statin-associated myopathy and skeletal muscle damage. CMAJ 2009;181 (1-2) (July 7).)

Muscle Injury from Statins Can Hide Behind Normal Lab Tests (Muskelskader fra statiner kan gjemme seg bak normale laboratorietester)
medpagetoday.com 6.7.2009
SAN FRANCISCO, July 6 -- Persistent muscle pain in patients taking statins may indicate structural damage to the muscles even when laboratory tests are normal, researchers found.

Biopsy-assessed muscle fiber damage was seen in about 57% of patients with statin-related myopathy compared with 0% in controls (P<0.001), Annette Draeger, MD, of the University of Bern, Switzerland, and colleagues, reported in the July 7 issue of CMAJ.

But only one of these 44 myopathy patients in the study had abnormal serum creatine phosphokinase levels.

Muscle pain associated with statin therapy has typically been dismissed as a minor adverse effect by both patients and physicians, the researchers noted. (...)

Only one patient -- a case of overt rhabdomyolysis that required hospitalization -- had a creatine phosphokinase above the upper limit of normal (57,657 U/L) and these levels alone did not distinguish patients who had and had not taken statins, they said.

One potential distinguishing feature was the significantly higher expression of ryanodine receptor 3 mRNA in patients with structural muscle damage than in those without damage (P=0.039).

However, the mechanistic and diagnostic implications of this are unclear, Dr. Draeger's group said. (...)

Statins Can Hinder Muscle Repair (Statiner kan forhindre muskelreperasjon)
healthfinder.gov 25.9.2008
Small number of patients taking them will experience damage, experts say. (...)

THURSDAY, Sept. 25 (HealthDay News) -- Statins, taken by millions to lower cholesterol, may hinder the body's ability to repair muscles, University of Alabama researchers report.

The most frequently reported side effect of statin therapy is fatigue, with about 9 percent of patients reporting muscle pain. As doses of the medication are increased, and physical activity is added, these effects can be more pronounced. These side effects are found in all commonly used statins. (...)

Results of the study were presented Thursday at a meeting of the American Physiological Society, in Hilton Head, S.C.

For the study, Thalacker-Mercer's team exposed muscle cells to varying doses of simvastatin.

The researchers found as the dosage increased, the ability of these cells to multiply decreased. For the equivalent of 40 milligrams a day, growth of new muscle cells was reduced by 50 percent. (...)

Between 2 percent and 8 percent of patients report having muscle aches in response to statins, Fonarow noted. "Significant muscle damage as result of statin treatment rarely occurs, but if it does, there can be serious consequences," he noted. (...)

- Smertefulle bivirkninger i musklene

Smertefulle bivirkninger i musklene
Forskningsartikkel
apollon.uio 28.11.2006
OVERSER PROBLEMET: Professor Anders Åsberg ved Farmasøytisk institutt sier at legene i stor grad overser problemet med at medisiner mot kolesterol kan føre til muskelsmerter.

300 000 nordmenn tar kolesteroldempende medisiner. Hver tiende får smertefulle og influensalignende bivirkninger i musklene. (...)

Det viser seg at hver tiende nordmann som bruker kolesteroldempende legemidler, får muskelsmerter på kjøpet. Det kan dreie seg om alt fra ”giktsmerter” til så vonde influensalignende smerter i musklene at man ikke orker å gå i trapper. For de uheldigste, og det skjer ti til femten ganger hvert år, går muskelcellene i stykker og lekker ut stoffer i blodet som kan ødelegge nyrene. Dødsfall har forekommet.

De to farmasøytene undersøkte bivirkningene til verdens mest solgte kolesterolsenkende medisin, Lipitor, men undersøkelsen er sannsynligvis også gyldig for lignende medisiner som Zocor, Pravachol og Lescol. De inneholder alle det kjemiske stoffet statin. (...)

- Statiner kan indusere myasthenia gravis

Statins can induce myasthenia gravis (Statiner kan indusere myasthenia gravis)
J Clin Neurosci. 2014 Feb;21(2):195-7.
The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, are commonly prescribed for prevention of cardiovascular morbidity. A rare side effect of statin medication is the induction of autoimmune illnesses, including myasthenia gravis (myasthenia). Here we present two patients with seropositive myasthenia that developed 4 weeks after initiation of atorvastatin, increasing the total reported patients to seven. Reviewing recent literature we highlight the connections between statins, auto-immunity and myasthenia. Statins may favour T-cell phenotypes that reduce cell-mediated immunity but could increase antibody-mediated humoral immunity. (...)

(Anm: Myasthenia gravis er en sykdom som fører til muskelsvakhet og økt trettbarhet i muskulaturen. Forskjellige muskelgrupper kan rammes i ulik grad. Tilstanden regnes som en autoimmun sykdom der impulsoverføringen fra nerve til muskel er forstyrret. (nhi.no).)

Medikamenter som kan utløse og forverre myasthenia gravis
Tidsskr Nor Legeforen 2013; 133:296 – 9 (5.2.2013)
Behandling av pasienter med myasthenia gravis er en spesialistoppgave, men alle leger vil kunne komme i kontakt med pasientgruppen i forbindelse med andre tilstander. En rekke medikamenter som brukes for andre samtidige sykdommer, kan forverre muskelsvakheten eller utløse en myasteniliknende tilstand. Vi gir her en oversikt over de vanligste medikamenter som bør brukes med forsiktighet hos disse pasientene.

Myasthenia gravis er en autoimmun sykdom som hemmer den nevromuskulære signaloverføringen ved at det dannes autoantistoffer rettet mot acetylkolinreseptorer (1). Behandling er en spesialistoppgave. Den primære medikamentelle behandlingen er basert på bruk av kolinesterasehemmere, f.eks. pyridostigmin, som ved å hemme nedbrytingen øker mengden av tilgjengelig acetylkolin og dermed reduserer symptomene. Det er ofte nødvendig å kombinere dette med steroidbehandling og immunsuppressiver (2). (...)

- Statiner og muskel- og skjelettlidelser, artropatier og skader (autoimmune sykdommer)

Statins and Musculoskeletal Conditions, Arthropathies, and Injuries (Statiner og muskel- og skjelettlidelser, artropatier og skader)
JAMA Intern Med. 2013;173(14):1318-1326 (July 22, 2013)
Importance Statin use may be associated with increased musculoskeletal adverse events, especially in physically active individuals.

Objective To determine whether statin use is associated with musculoskeletal conditions, including arthropathy and injury, in a military health care system.

Konklusjoner og relevans Muskel- og skjelettlidelser, artropatier, skader og smerte er mer vanlig blant statinbrukere enn blant lignende ikke-brukere. Hele spekteret for statiners muskel- og skjelettlidelser og uønskede hendelser er kanskje fullt utforsket, og ytterligere studier er berettiget, spesielt på fysisk aktive individer. (...) (Conclusions and Relevance Musculoskeletal conditions, arthropathies, injuries, and pain are more common among statin users than among similar nonusers. The full spectrum of statins’ musculoskeletal adverse events may not be fully explored, and further studies are warranted, especially in physically active individuals.)

(Anm: Artropati, leddplager. Kilde: Store norske leksikon.)

(Anm: Statin-Associated Autoimmune Myopathy. (…) It is now recognized, however, that in very rare cases, an autoimmune myopathy develops in patients treated with statins; this disorder is characterized by muscle weakness, evidence of muscle-cell necrosis on biopsy, and the presence of autoantibodies against 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase.5-16 In contrast to most patients who have side effects from statin therapy, those with statin-associated autoimmune myopathy may have progressive weakness that must be controlled with immunosuppressive therapy. This review describes the clinical characteristics, diagnosis, proposed pathologic mechanisms, and treatment of statin-associated autoimmune myopathy. N Engl J Med 2016; 374:664-669 (February 18, 2016).)

- Kraftige statiner kan øge risiko for akut nyreskade

Kraftige statiner kan øge risiko for akut nyreskade
dagensmedicin.dk 10.4.2013
Patienter i behandling med kraftige statiner har 34 pct. større risiko for at blive indlagt med akut nyreskader i forhold til patienter, der bliver behandlet med ikke-kraftige statiner.

Brugen af højpotente statiner er forbundet med en større risiko for at blive indlagt med akut nyreskader end brug af mindre kraftige statiner. Det viser en omfattende undersøgelse fra Canada, der offentliggjort i tidsskriftet BMJ. Den højere risiko varede tilmed to år efter behandlingen blev indledt.

Ordination af kolesterolsænkende statiner med stærkere virkning er blevet mere udbredt til behandling af de mest udsatte patienter, hvilket har fået forskere til at bekymre sig over, om de kraftige doser af statiner kan føre til nyreskader.

I den aktuelle undersøgelse sammenlignede forskerne patienter, der fik ordineret kraftige statiner, med patienter, der fik ordineret mindre kraftige statiner i syv canadiske provinser samt gennem to internationale databaser I USA og England, i perioden mellem 1997-2008. (...)

Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases (Bruk av høypotente statiner og rater for innleggelser for akutte nyreskader: multisenter, retrospektiv observasjonsstudier analyse av administrative databaser)
BMJ 2013;346:f880 (19 March 2013)
(...) Objective To quantify an association between acute kidney injury and use of high potency statins versus low potency statins.

Design Retrospective observational analysis of administrative databases, using nine population based cohort studies and meta-analysis. We performed as treated analyses in each database with a nested case-control design. Rate ratios for different durations of current and past statin exposure to high potency or low potency statins were estimated using conditional logistic regression. Ratios were adjusted for confounding by high dimensional propensity scores. Meta-analytic methods estimated overall effects across participating sites.

Setting Seven Canadian provinces and two databases in the United Kingdom and the United States.
Participants 2 067 639 patients aged 40 years or older and newly treated with statins between 1 January 1997 and 30 April 2008. Each person hospitalized for acute kidney injury was matched with ten controls.

Intervention A dispensing event was new if no cholesterol lowering drug or niacin prescription was dispensed in the previous year. High potency statin treatment was defined as ≥10 mg rosuvastatin, ≥20 mg atorvastatin, and ≥40 mg simvastatin; all other statin treatments were defined as low potency. Statin potency groups were further divided into cohorts with or without chronic kidney disease.
Main outcome measure Relative hospitalization rates for acute kidney injury.

Results Of more than two million statin users (2 008 003 with non-chronic kidney disease; 59 636 with chronic kidney disease), patients with similar propensity scores were comparable on measured characteristics. Within 120 days of current treatment, there were 4691 hospitalizations for acute kidney injury in patients with non-chronic kidney injury, and 1896 hospitalizations in those with chronic kidney injury. In patients with non-chronic kidney disease, current users of high potency statins were 34% more likely to be hospitalized with acute kidney injury within 120 days after starting treatment (fixed effect rate ratio 1.34, 95% confidence interval 1.25 to 1.43). Users of high potency statins with chronic kidney disease did not have as large an increase in admission rate (1.10, 0.99 to 1.23). χ2 tests for heterogeneity confirmed that the observed association was robust across participating sites.

Conclusions Use of high potency statins is associated with an increased rate of diagnosis for acute kidney injury in hospital admissions compared with low potency statins. The effect seems to be strongest in the first 120 days after initiation of statin treatment. (...)

(Anm: Niacin for cholesterol now linked to death risk, dangerous side effects and no benefits (medicalnewstoday.com 19.7.2014).)

(Anm: Objective To describe the estimated prevalence and temporal trends of chronic kidney disease (CKD) treatment patterns, and the association between CKD and potential factors for type 2 diabetes mellitus (T2DM) in different demographic subgroups. (…) Conclusions CKD continued to be prevalent in the T2DM population; prevalence remained fairly consistent over time, suggesting that current efforts to prevent CKD could be improved overall, especially by monitoring certain populations more closely. BMJ Open Diab Res Care  2016;4:e000154.)

(Anm: Chronic Kidney Disease (CKD) (webmd.com 18.12.2016).)

(Anm: LNT - Landsforeningen for Nyrepasienter og Transplanterte (lnt.no).)

(Anm: LNT - Statistikk (lnt.no).)

(Anm: Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. (…) Interpretation. Prevalence of chronic kidney disease was high in general and high-risk populations from countries of low and middle income. Moreover, awareness of chronic kidney disease and other non-communicable diseases was low, and a substantial number of individuals who knew they were ill did not receive treatment. Prospective programmes with repeat testing are needed to confirm the diagnosis of chronic kidney disease and its risk factors. Furthermore, in general, health-care workforces in countries of low and middle income need strengthening.Lancet Glob Health 2016;4(5):e307–19 (May 2016).)

(Anm: IgA Nephropathy: New Aspects in Pathophysiology and Pathogenesis. (…) This disease may also be acquired depending on numerous environmental factors: exposure to certain exoantigens (infectious organisms, food, etc.), involvement of specific cytokines that can induce the production of Gd-IgA1, and modification of the different players potentially involved (immune response to autoantigens, abnormalities in receptors such as TfR and CD89, tissue TG2 status, etc.). EMJ Neph. 2015;3[1]:97-103.)

(Anm: Autoimmun attack kan ligga bakom njursvikt. Interstitiell nefrit, som är en vanlig orsak till njursvikt, har en komplex och i stora delar okänd bakgrund. Nu visar forskare i en studie ledd från Karolinska institutet hur interstitiell nefrit kan utvecklas genom en autoimmun attack mot njurens samlingsrör. Fynden publiceras i tidskriften Journal of the American Society of Nephrology (JASN). (ki.se 11.11.2015) (Karolinska Institutet).)

(Anm: Identification of a driver of fibrosis in chronic kidney disease. (medicalnewstoday.com 22.1.2016).)

(Anm: Chronic kidney disease in elderly people: disease or disease label? Timothy Ellam and colleagues argue for a focus on what diagnosis means for individual patients rather than population risks. Around half of people aged over 75 meet current diagnostic criteria for chronic kidney disease (CKD). However, labelling them all as diseased is controversial and may cause unnecessary anxiety.1 2 The classification system defining this epidemic of CKD in elderly people is validated primarily as an epidemiological risk stratification tool rather than a clinical aid to patient management. We highlight the need to focus the debate on improving patient centred outcomes rather than just identifying everyone at above average risk. BMJ 2016;352:h6559 (Published 18 January 2016).)

(Anm: Polycystic kidney disease: a diet dividend. New research from UC Santa Barbara suggests that reducing food intake may slow the growth of the cysts that are symptomatic of PKD, an inherited disorder in which clusters of cysts develop in the kidneys. (medicalnewstoday.com 29.1.2016).)

(Anm: Mitochondria: a new therapeutic target in chronic kidney disease. Nutr Metab (Lond). 2015 Nov 25;12:49.) (PDF)

(Anm: Chronic kidney disease may cause diabetes. A team from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a novel link between chronic kidney disease and diabetes. When kidneys fail, urea that builds up in the blood can cause diabetes, concludes a study published today in the Journal of Clinical Investigation. (medicalnewstoday.com 16.8.2016).)

(Anm: Kidney Impairment Decreases Blood Flow to the Brain, Boosting Risk of Stroke and Dementia (dgnews.docguide.com 6.8.2015).) 

(Anm: Chronic kidney disease may cause diabetes. A team from the University of Montreal Hospital Research Centre (CRCHUM) has discovered a novel link between chronic kidney disease and diabetes. When kidneys fail, urea that builds up in the blood can cause diabetes, concludes a study published today in the Journal of Clinical Investigation. (medicalnewstoday.com 16.8.2016).) (PDF)

(Anm: Abdominal Obesity Is More Closely Associated With Diabetic Kidney Disease Than General Obesity. Diabetes Care  2016 Aug; dc161025).) 

(Anm: Kidney Function: What Do The Kidneys Do? Contents of this article: 1.Structure and function of the kidneys 2.Diseases of the kidney and their cause 3. Kidney dialysis and maintaining healthy kidneys. (medicalnewstoday.com 4.2.2016).)

(Anm: IgA Nephropathy. What is IgA nephropathy? IgA nephropathy is a kidney disorder that occurs when IgA—a protein that helps the body fight infections—settles in the kidneys. After many years, the IgA deposits may cause the kidneys to leak blood and sometimes protein in the urine. (niddk.nih.gov).) 

(Anm: Even small reductions in kidney function may damage heart, blood vessels. Even small reductions in kidney function are associated with heart and blood vessel damage, according to new research in the American Heart Association's journal Hypertension. (medicalnewstoday.com 8.1.2016).)

- Gjør statiner deg dum?

Kolesterolpiller giver huskebesvær
bt.dk 30.3.2012
(...) Ikke færre end 600.000 danskere tager kolesterolsænkende midler. Medicin med en del bivirkninger. Ny rapport fortæller om bl.a. flere med hukommelsesbesvær.

Op imod 600.000 danskere tager medicin mod forhøjet kolesterol - et meget højt tal. Medicin, som ofte har bivirkninger i form af muskelømhed, fordøjelsesbesvær, hovedpine, søvnløshed, forstyrrelser i sexdriften o.a. Senest har sundhedsmyndighederne i USA - Food and Dryg Administration - advaret om flere bivirkninger i form af hokommelsessvigt og øget risiko for at få type 2 diabetes. (...)

Do Statins Make You Stupid? (Gjør statiner deg dum?)
nytimes.com 17.2.2008
Cholesterol-lowering statin drugs have had a rough time of it lately.

There was the headline-making trial of the statin-combination drug Vytorin, which rattled conventional wisdom about the value of lowering cholesterol. Business Week weighed in with a report that asked: “Do Cholesterol Drugs Do Any Good?” And my Well column in Science Times last month pointed out that there’s no data to show that statins prolong the lives of many people who use them. (...)

To read the full article, click here. (...)

Can a Drug That Helps Hearts Be Harmful to the Brain?
online.wsj.com 12.2.2008
Cognitive side effects like memory loss and fuzzy thinking aren't listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds. (...)

- Tror at mitokondrieskader kan føre til Alzheimers sykdom

Mitochondria, Diabetes, and Alzheimer’s Disease
Diabetes 2012; 61(5): 991-992 (May)
Alzheimer’s disease (AD) is the most common neurodegenerative disease as well as the leading cause of dementia (1,2). Identification of disease-causing mutations in the amyloid precursor protein, presenilin 1, and presenilin 2 has unraveled the molecular basis of some forms of familial AD, but the etiology and pathogenesis of sporadic AD remain elusive and controversial. Epidemiological data suggest that diabetes increases the risk of developing AD (2–4). These data are corroborated by clinical and laboratory findings. Indeed, diabetic subjects show signs of cognitive dysfunction, leukoariosis, and more severe hippocampal atrophy than control subjects (5). In addition, neuritic plaques and neurofibrillary tangles, the pathological hallmarks of AD, accumulate more abundantly in the brains of diabetic patients relative to control subjects. The association between diabetes and AD pathology seems even stronger among carriers of the apolipoprotein E ε4 allele, a variant that by itself carries an increased risk for AD (6). (...)

(Anm: Simvastatin impairs ADP-stimulated respiration and increases mitochondrial oxidative stress in primary human skeletal myotubes (Simvastatin svekker ADP-stimulert respirasjon og øker mitokondrielt oksydativt stress i primære menneskelige skjelett myotuber) Free Radic Biol Med. 2012 Jan 1;52(1):198-207. Epub 2011 Oct 25.)

(Anm: Statins: Is It Really Time to Reassess Benefits and Risks? (Statiner: Er det i virkeligheten på tide at man revurderer nytte og risiko?) N Engl J Med 2012; 366:1752-1755May 10, 2012 - No drug provides health benefits without some degree of risk, and risk–benefit assessments require ongoing review as new data become available. This is certainly the case for the use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors — statins — and the risk of new-onset diabetes.)

Abnormal Mitochondrial Dynamics in the Pathogenesis of Alzheimer's Disease
J Alzheimers Dis. 2012 Apr 24. [Epub ahead of print]
Abstract Mitochondrial dysfunction is one of the most early and prominent features in vulnerable neurons in the brain of Alzheimer's disease (AD) patients. Recent studies suggest that mitochondria are highly dynamic organelles characterized by a delicate balance of fission and fusion, a concept that has revolutionized our basic understanding of the regulation of mitochondrial structure and function which has far-reaching significance in studies of health and disease. Tremendous progress has been made in studying changes in mitochondrial dynamics in AD brain and models and the potential underlying mechanisms. This review highlights the recent work demonstrating abnormal mitochondrial dynamics and distribution in AD models and discusses how these abnormalities may contribute to various aspects of mitochondrial dysfunction and the pathogenesis of AD. (...)

Tror at mitokondrieskader kan føre til Alzheimer
dagensmedicin.se 17.2.2011
Nye funn antyder at skade av mitokondrielt arvemateriale kan gi nevrodegenerativ sykdom.

Doktorgradsstipendiat Knut Husø Lauritzen har funnet interessante assosiasjoner mellom mitokondrielt DNA (mtDNA) og hjernefunksjon hos mus.

Skadelig protein
Ved å gi dyrene en diett med et protein som skader mtDNA, kunne Husø Lauritzen studere effektene av dette.

Han fant at nevroner i hippocampus, senteret i hjernen som er assosiert med læring og hukommelse og som er sterkt preget i sykdommmer som Alzheimers, i stor grad påvirkes av skader på mtDNA.

Nervecellene dør
Mitokondrier er viktig for nervevev som har et høyt energibehov. Husø Lauritzen fant at skadene på arvematerialet i disse energiproduserende organellene ga nedbrytning og død av nerveceller.

Nettopp dette karakteriserer nevrodegenerative sykdommer.

Nedsatt læringsevne
Hos musene ble det observert en uvanlig adferd med nedsatt læringsevne. Det ble også blant annet oppdaget kollaps av mitokondriell dynamikk og distribusjon, med opphoping av mitokondrier i den nervecellekroppen og påfølgende reduksjon i synapseområder der energi er viktig for overføring av nervesignaler.

Husø Lauritzen disputerer for sin doktorgrad ved Universitetet i Oslo 21. februar. (...)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

(Anm: Linking telomere loss and mitochondrial dysfunction in chronic disease. (…) Drawing a mechanistic connection between telomere function and mitochondria biology will provide a broader perspective for understanding the pathophysiology of diseases and their relation to the aging process, and may provide opportunities for new possible treatments. Front Biosci (Landmark Ed). 2017 Jan 1;22:117-127.)

(Anm: Extreme short and long telomeres linked to increased cancer risk (news-medical.net 5.4.2017).)

(Anm: Scientists discover master regulator of cellular aging. (…) "Telomeres represent the clock of a cell," said TSRI Associate Professor Eros Lazzerini Denchi, corresponding author of the new study, published online in the journal Science. "You are born with telomeres of a certain length, and every time a cell divides, it loses a little bit of the telomere. Once the telomere is too short, the cell cannot divide anymore." (medicalnewstoday.com 13.1.2017).)

(Anm: Betennelser endrer mitokondrier til giftige fabrikker. Å lære hvordan å kontrollere betennelser kan ha store implikasjoner for behandlingen av mange sykdommer. Banebrytende forskning oppdager hvordan makrofager endrer mitokondriene til giftige kjemisk-produserende betennelsespromotører. (Inflammation turns mitochondria into toxic factories. Learning how to control inflammation could have huge implications for the treatment of many diseases. Breaking research discovers how macrophages turn mitochondria into toxic chemical-producing inflammation-promoters.) (medicalnewstoday.com 25.9.2016).)

(Anm: Research may show new ways to repress inflammation at outset. (…) Professor Alexander Weber of the Interfaculty Institute of Cell Biology says the enzyme - Bruton's tyrosine kinase or BTK - is switched on when an inflammation occurs in the body, playing a key role in the inflammation's subsequent development. (medicinenet.com 21.2.2017).)

(Anm: Ørsmå mitokondrier spiller en svært stor rolle mht. menneskets evolusjon og sykdom (Tiny mitochondria play outsized role in human evolution and disease.) (medicalnewstoday.com 25.9.2015).)

Mitokondrienes rolle ved Alzheimers sykdom
Tidsskr Nor Legeforen 2009; 129:400 (26.2.2009)
Mitokondrienes selvdestruksjonsmekanisme medvirker trolig til utvikling av Alzheimers sykdom.

Man vet at avleiring av β-amyloide plakk i hjernen er viktig i patogenesen ved Alzheimers sykdom. Man vet også at mitokondriene skades av løselig β-amyloid. En amerikansk forskergruppe har nå vist ved cellestudier at løselig β-amyloid i mitokondriene interagerer med proteinet cyklofilin D (CypD), og dette øker mitokondrielt stress. Funnene indikerte i tillegg at interaksjonen mellom løselig β-amyloid og CypD åpner poren mPTP i den indre mitokondriemembranen, noe som medfører en influks av kalsiumioner med påfølgende mitokondrieskade (1). (...)

(Anm: Alzheimers sykdom og andre årsaker til demens. (mintankesmie.no).)

- Legemiddelverket advarer mot kolesterolmedisiner

Legemiddelverket advarer mot kolesterolmedisiner
tv2nyhetene.no 5.3.2012
Mange eldre bruker kolesterolmedisin uten at det er nødvendig, og medisinen kan dessuten gi alvorlige bivirkninger, advarer Legemiddelverket.

– Vi ser en tendens til at mange eldre som ikke har hatt hjertesykdom, får kolesterolmedisiner med såkalte statiner, uten at de har noen nytte av dem, sier fagdirektør Steinar Madsen i Legemiddelverket til VG. (...)

- Som hjertespesialist er jeg glad for at det kolesterolsenkende legemidlet simvastatin nå er så billig at det kanskje ville være samfunnsøkonomisk lønnsomt å helle det i drikkevannet

Legemiddelbruk i Norge – for lite, for mye eller passe?
Madsens blogg - Steinar Madsen er medisinsk fagdirektør ved Statens legemiddelverk. Han er utdannet lege og har arbeidet ved Bærum sykehus og Rikshospitalet. Ved siden av Legemiddelverket har han deltidsstilling som privatpraktiserende spesialist i indremedisin og hjertesykdommer.
dagensmedisin.no 17.4.2012
(...) Som hjertespesialist er jeg glad for at det kolesterolsenkende legemidlet simvastatin nå er så billig at det kanskje ville være samfunnsøkonomisk lønnsomt å helle det i drikkevannet. Forebygging av tidlig død av hjerte- og karsykdom har vært svært vellykket de siste 20-30 årene. (...)

Forleden hadde jeg en pasient til utredning. Det var en 74 år gammel mann med høyt blodtrykk, diabetes type 2, KOLS og forkammerflimmer. Det nedslående resultatet av mine undersøkelser var: Blodtrykket var ikke godt behandlet, hans diabetes var ute av kontroll, medisinen han fikk for KOLS var kke den beste og han fikk ikke blodfortynnende behandling til tross for at etningslinjene sier han skulle hatt det. Han kom med fire legemidler og gikk med sju. (...)

(Anm: Miljø og legemiddel (Legemidler er farlig avfall). (mintankesmie.no).)

- Kolesterol-debatten

Risk of incident diabetes among patients treated with statins: population based study (Risiko for tilfeller med diabetes blant pasienter behandlet med statiner: befolkningsbasert studie)
BMJ 2013;346:f2610 (23 May 2013)
(...) Objective To examine the risk of new onset diabetes among patients treated with different HMG-CoA reductase inhibitors (statins).
Design Population based cohort study with time to event analyses to estimate the relation between use of particular statins and incident diabetes. Hazard ratios were calculated to determine the effect of dose and type of statin on the risk of incident diabetes. (...)

Results Compared with pravastatin (the reference drug in all analyses), there was an increased risk of incident diabetes with atorvastatin (adjusted hazard ratio 1.22, 95% confidence interval 1.15 to 1.29), rosuvastatin (1.18, 1.10 to 1.26), and simvastatin (1.10, 1.04 to 1.17). There was no significantly increased risk among people who received fluvastatin (0.95, 0.81 to 1.11) or lovastatin (0.99, 0.86 to 1.14). The absolute risk for incident diabetes was about 31 and 34 events per 1000 person years for atorvastatin and rosuvastatin, respectively. There was a slightly lower absolute risk with simvastatin (26 outcomes per 1000 person years) compared with pravastatin (23 outcomes per 1000 person years). Our findings were consistent regardless of whether statins were used for primary or secondary prevention of cardiovascular disease. Although similar results were observed when statins were grouped by potency, the risk of incident diabetes associated with use of rosuvastatin became non-significant (adjusted hazard ratio 1.01, 0.94 to 1.09) when dose was taken into account.

Conclusions Compared with pravastatin, treatment with higher potency statins, especially atorvastatin and simvastatin, might be associated with an increased risk of new onset diabetes. (...)

(Anm: Diabetes (mintankesmie.no).)

Should You Take Statins? Study Says Heart Benefits Outweigh Diabetes Risk (Bør du ta statiner? Studie sier hjertefordeler oppveier diabetesrisiko)
healthland.time.com 10.8.2012 (Time)
The new findings clarify the Type 2 diabetes risks associated with statins, but the debate over who should be taking the cholesterol-lowering drugs is likely to persist

In February, the U.S. Food and Drug Administration (FDA) added a new warning to cholesterol-lowering statin drugs, noting the increased risk of Type 2 diabetes in users. But now a new study suggests that the cardiovascular benefits of taking the drugs may outweigh any potential diabetes risk.

The new study, published in the journal Lancet, analyzed existing data from the well-known and controversial 2008 JUPITER trial (for Justification for the Use of Statins in Primary Prevention), which tested a single statin, Crestor (rosuvastatin), for the prevention of heart disease in healthy people with no history of heart problems. (...)

Hjerteforeningen kritiseres for at overdrive kolesterolfrygt
b.dk 22.4.2012
En af Danmarks største patientforeninger, Hjerteforeningen, møder nu skarp kritik fra flere sider. Det sker, efter foreningen i søndags meddelte, at 30.000 danskere vil dø inden for en tiårig periode, hvis ikke yderligere 900.000 danskere begynder at tage kolesterolsænkende medicin.

Men det budskab bliver nu udfordret af en række eksperter, der sætter store spørgsmålstegn ved lødigheden af Hjerteforeningens videnskabelige grundlag i rapporten, som er udarbejdet af Børge Nordestgaard, professor ved Herlev Hospital. Det fortæller TV 2 Nyhederne.

Jens Søndergaard, speciallæge i lægemidler og professor ved SDU, har gennemgået rapporten, og han har fundet i alt 11 kritikpunkter. (...)

Risk of Diabetes, Cognitive Problems With Statins Sparks Debate About Overuse (Risiko for diabetes, kognitive problemer med statiner utløser debatt om overforbruk)
JAMA 2011 (March 5)
Updated US Food and Drug Administration (FDA) warnings that use of cholesterol-lowering statins can increase the risk of developing diabetes, liver injury, cognitive problems, and muscle injury for some patients have renewed criticism about overuse of this class of medications.

Last week, the FDA announced changes to the labels of statin medications, which include atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin, and combination products containing these drugs. The label changes indicate that these products may be associated with memory loss or confusion, an increased risk of developing type 2 diabetes, and increased risk of muscle injury when used in combination with drugs for the treatment of HIV or hepatitis C virus infection. (...)

FDA adds diabetes, memory loss warnings to statins (FDA tilføyer advarsler om diabetes, hukommelsestap for statiner)
reuters.com 28.2.2012
(Reuters) - Health regulators are adding warnings to the labels of widely used cholesterol lowering drugs, such as Lipitor, to say they may raise levels of blood sugar and could cause memory loss.

The Food and Drug Administration announced on Tuesday the changes to the safety information on the labels of statins such as Pfizer Inc's Lipitor, AstraZeneca's Crestor and Merck & Co's Zocor that are taken by tens of millions of people.

Statins have been shown to significantly reduce the risk of heart attack and heart disease, and the FDA said the new information should not scare people into stopping taking the drugs. (...)

Safety Alerts Cite Cholesterol Drugs’ Side Effects (Sikkerhetsadvarsel opplyser om sideffekter for kolesterollegemidler)
nytimes.com 1.3.2012
Federal health officials on Tuesday added new safety alerts to the prescribing information for statins, the cholesterol-reducing medications that are among the most widely prescribed drugs in the world, citing rare risks of memory loss, diabetes and muscle pain.

Federal health officials said these widely prescribed drugs could cause elevated blood sugar and problems with memory.

It is the first time that the Food and Drug Administration has officially linked statin use with cognitive problems like forgetfulness and confusion, although some patients have reported such problems for years. Among the drugs affected are huge sellers like Lipitor, Zocor, Crestor and Vytorin. (...)

Poor Cognitive Function and Risk of Severe Hypoglycemia in Type 2 Diabetes
Post hoc epidemiologic analysis of the ACCORD trial

Diabetes Care 2012 (Published online before print February 28, 2012)
(...) OBJECTIVE Self-management of type 2 diabetes including avoidance of hypoglycemia is complex, but the impact of cognition on safe self-management is not well understood. This study aimed to assess the effect of baseline cognitive function and cognitive decline on subsequent risk of severe hypoglycemia and to assess the effect of different glycemic strategies on these relationships. (...)

CONCLUSIONS Poor cognitive function increases the risk of severe hypoglycemia in patients with type 2 diabetes. Clinicians should consider cognitive function in assessing and guiding their patients regarding safe diabetes self-management regardless of their glycemic targets. (...)

Risiko for udvikling af diabetes hos patienter i statinbehandling
laegemiddelstyrelsen.dk 19.1.2012
Den Europæiske Bivirkningskomité, PhVWP, har afsluttet en undersøgelse vedrørende en mulig risiko for udvikling af diabetes hos patienter i behandling med HMG-CoA reducatsehæmmere (statiner).

Konklusionen på undersøgelsen blev, at der er evidens for en kausal sammenhæng mellem brug af HMG-CoA reducatasehæmmere og udvikling af diabetes hos patienter, som er i højrisiko for udvikling af diabetes. Konklusionen blev imidlertid også, at fordelene fortsat stærkt opvejer de mulige risici ved behandlingen, også hos patienter, som er i højrisiko for udvikling af diabetes, eller som allerede har diabetes ved initiering af behandlingen.

Produktinformationen for alle godkendte statiner i EU bliver opdateret med:

• En advarsel om, at HmG-CoA reductasehæmmere kan øge blodsukkerniveauet hos patienter, som er i højrisiko for udvikling af diabetes.
• Patienter i statinbehandling, som er i højrisiko for udvikling af diabetes – fx har fasteblodsukker på 5.6-6.9 mmol/l, BMI >30, forhøjede triglycerider eller hypertension, bør monitoreres tæt både klinisk og biokemisk.

Endvidere vil diabetes mellitus blive inkluderet som en almindeligt forekommende bivirkning, det vil sige opstår hos mere end 1 ud 100 patienter og mindre end 1 ud 10 patienter.

Læs mere i PhVWP’s månedsrapport fra december 2011.

Statins Up Diabetes Risk in Older Women (Statiner øker diabetesrisiko hos eldre kvinner)
medpagetoday.com 9.1.2012
Older women who take statins may be at an increased risk for developing type 2 diabetes, researchers found.

In an analysis of data from the Women's Health Initiative, postmenopausal women who were on a statin at study entry had almost a 50% greater risk of diabetes than those who weren't on the cholesterol-lowering drugs, Yunsheng Ma, MD, PhD, of the University of Massachusetts School of Medicine, and colleagues reported online in the Archives of Internal Medicine.(...)

(Anm: Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. Arch Intern Med 2012 (Published online January 9).)

Statin Use and Risk of Diabetes Mellitus in Postmenopausal Women in the Women's Health Initiative
Arch Intern Med. 2012 (Published online January 9)
Background This study investigates whether the incidence of new-onset diabetes mellitus (DM) is associated with statin use among postmenopausal women participating in the Women's Health Initiative (WHI). (...)

Conclusions Statin medication use in postmenopausal women is associated with an increased risk for DM. This may be a medication class effect. Further study by statin type and dose may reveal varying risk levels for new-onset DM in this population. (...)

Statins Tied to Lung Damage in Smokers (Statiner knyttet til lungeskade hos røykere)
medpagetoday.com 6.1.2012
Statin use appears to be associated with interstitial lung abnormalities among current and former smokers, researchers found.

Among individuals with a history of at least 10 pack-years of smoking, statin use was associated with a 60% increase in the odds of having abnormalities on CT scans (OR 1.60, 95% CI 1.03 to 2.50), according to Gary Hunninghake, MD, MPH, of Brigham and Women's Hospital in Boston, and colleagues.

The findings were independent of a history of high cholesterol, coronary heart disease, or a number of other cardiovascular risk factors, the researchers reported online in the American Journal of Respiratory and Critical Care Medicine. (...)

(Anm: Statins do not benefit patients with lung cancer, new study shows (medicalnewstoday.com 28.2.2017).)

Kolesterolverdier: Høyere dødelighet under fem
dagensmedisin.no 27.10.2011
Totaldødeligheten for kvinner med totalkolesterol under fem er høyere enn ved totalkolesterol på syv eller mer. Resultatene sår tvil om gjeldende risikoberegninger og retningslinjer, mener forskeren bak en norsk studie.

TRONDHEIM: For hver 1.0 mmol/l økning i totalkolesterol er det en statistisk signifikant reduksjon for totaldødelighet på 6 prosent for kvinner, men ikke for menn. Totaldødeligheten ved kolesterolnivå under 5 er også signifikant høyere enn ved totalkolesterol på 7, men bare for kvinner.

Dette fremgår av en norsk studie som ble presentert på Nidaroskongressen i forrige uke. Studien er nylig forhåndspublisert på nett i Journal of Evaluation in Clinical Practice. (...)

Den store kolesterolfuser
information.dk 17.7.2011
Godt en halv million danskere tager kolesterolsænkende medicin. Næsten halvdelen gør det uden grund eller effekt. Eksperterne ryster på hovedet og kalder pillerne for et produkt af det moderne risikosamfund, hvor der bliver tjent penge på folks frygt. (...)

»Når lægerne udskriver medicin til almindelige, raske mennesker, så tror jeg, de fleste af dem ræsonnerer på den måde, at ‘jeg skal have medicin, altså er jeg syg’, og vi er kede af, hvis folk begynder at opfatte sig selv som patienter, når de er friske og raske og burde nyde livet,« siger Niels Christian Heebøll- Nielsen. (...)

Data Mining Approach Shows Promise in Detecting Unexpected Drug Interactions
JAMA. 2011;306(2):144 (July 20)
Up to 1 million patients in the United States may be taking 2 medications that can lead to unexpected increases in blood glucose levels when used simultaneously. Data mining techniques have revealed that the combination of the antidepressant paroxetine and the cholesterol-lowering medication pravastatin may cause this adverse effect (Tatonetti NP et al. Clin Pharmacol Ther. doi: 10.1038/clpt.2011.83 [published online ahead of print May 25, 2011]).

“If a physician has a patient on these 2 medications and their diabetes becomes harder to control, the physician may want to consider changing the medications,” said principal investigator Russ Altman, MD, PhD, professor of bioengineering, genetics, and medicine at Stanford University. (...)

(Anm: Seroxat (Paxil) (paroxetine; paroksetin) (SSRI) (mintankesmie.no).)

F.D.A. Issues Safety Alert on Zocor (FDA utsteder sikkerhetsadvarsel for Zocor)
prescriptions.blogs.nytimes.com 8.6.2011
The Food and Drug Administration on Wednesday announced new safety restrictions on high-dose simvastatin, also known as Zocor, a cholesterol-lowering drug taken by an estimated 2.1 million Americans.

The agency said the 80-milligram dose caused a potentially severe muscle disease, called myopathy, especially in the first year of taking the medication.

No new patients should be put on the high dosage, the F.D.A. said, recommending that existing patients should continue only if they have used the drug for more than a year without experiencing muscle pains. Alternative statins may be safer, the agency said. (...)

Helsefarlige budskap
KJETIL RETTERSTØL - overlege, Lipidklinikken, Oslo Universitetssykehus
aftenposten.no 19.5.2011
Høyt kolesterol er farlig, sier noen, ikke noe å bry seg om, hevder andre. Det forskes kontinuerlig på feltet. I 1985 fikk Michael S. Brown og Joseph L. Goldstein Nobelprisen for arbeid med kolesterols metabolisme.

Akkumulerte kunnskapsbaser består nå av mer enn 1,5 millioner søkbare vitenskapelige artikler om emnet. Ny kunnskap nyanserer, men et budskap har likevel holdt seg godt i 50 år: Mettet fett øker blodkolesterol og risiko for hjerte- og karsykdom. Likevel finnes det unntak, slik er vitenskap. Problemet er når unntakene dominerer informasjonsbildet. (...)

VG glemte å måle kolesterolet
journalisten.no 6.5.2011
På venstre side advares det fra redaksjonen mot kolesterol, mens det på høyre side foreslås en løsning fra annonseavdelingen.

Slo helsealarm på redaksjonell plass og tipset om redningen på annonseplass rett ved siden. Klart brudd, mener Kokkvold.

Annonsen, som er kjøpt av Boots, Elixia, Grete Roede, Vita hjertegod og Nasjonalforeningen for folkehelsen, er som den berømte hånden i hansken for lesere med kolesterolangst. Men for presseetikeren smaker den heller dårlig.

– Dette er et klart brudd på god presseskikk og en uakseptabel kobling, sier generalsekretær Per Edgar Kokkvold i Norsk Presseforbund til Journalisten.

Han viser til tekstreklameplakatens punkt fem om at man ikke skal ta inn kommersielt materiale på en slik måte at skillelinjen mellom redaksjonelt innhold og markedsplass svekkes. (...)

Legene advarer mot kolesteroltest
aftenposten.no 5.5.2011
Nasjonalforeningen for folkehelsen ber alle voksne måle kolesterolet sitt på apotek. Legeforeningen er rystet over kampanjen og sier at den vil føre til helseangst i befolkningen.

Fra i dag kan alle over 18 år sjekke kolesterolnivået i blodet gratis på enkelte apoteker. Nasjonalforeningen for folkehelsen har etablert dette tilbudet sammen med fire kommersielle aktører og sier de gjør det for å redde liv. Men Legeforeningen anklager dem for å ville tjene penger på folks angst.

Bakgrunnen for kolesterolkampanjen «Har du under 5?» er at gjennomsnittsnordmannen har et kolesterolnivå på 5,8 mmol/l. Ifølge nasjonale retningslinjer er et tilfredsstillende nivå under 5,0. (...)

Leder for Norsk forening for allmennmedisin,(NFA), som representerer allmennlegene i Legeforeningen, Gisle Roksund, er oppgitt og opprørt over kampanjen. Han frykter at kommersielle interesser står bak. (...)

– Legene overser statinbivirkninger
dagensmedisin.no 4.5.2011
– Leger overser bivirkningsrisiko og bør være mer oppmerksomme på forsiktighetsregler ved statiner, mener farmasøyt og seniorrådgiver Kirsten Myhr i Relis. (...)

Minst 50.000 plages
Nye tall fra Reseptregisteret viser at 478.000 nordmenn tar kolesterolsenkende medisin.

Minst 50.000 opplever plagsomme bivirkninger. (...)

Birgitte (47) ble syk av kolesterol-medisin
tv2nyhetene.no 4.5.2011
Som 50.000 andre nordmenn fikk hun plagsomme bivirkninger. Men det hele kunne vært løst med en kopp kaffe.

Nesten en halv million nordmenn medisineres for høy kolesterol. Det er en økning på 47 prosent siden 2004. Mange opplever store plager på grunn av medisinene. Et mer bevisst forhold til kaffe kunne redusert problemet, mener en ernæringsprofessor. (...)

– Bør heller endre kosthold
Farmasøyt Kirsten Myhr mener norske leger overser bivirkningsrisikoen og er for ukritiske når de skriver ut statiner.
– Man bør først prøve seg med livstilsendringer som å endre kosthold, trene mer og slutte å røyke. Jeg tror det er viktig å prøve det før man tar en pille, sier Myhr.

– For kjapp med å medisinere
Birgitte Kallhovd fikk aldri opplysninger fra sin lege om at hun kunne få bivirkninger. Nå vil hun endre kostholdet og droppe medisinene totalt.
– De setter oss pasienter litt for raskt på medisiner istedet for å se på kostholdet vårt. Jeg kommer ikke til å gå tilbake til medisiner, jeg tør ikke. Jeg er blitt redd, så jeg velger heller diett, sier Kalhovd. (...)

Så mange epler bør du spise hver dag
kk.no 15.4.2011
Fire epler om dagen

Forskerne ble overrasket over eplenes potensiale da de fant ut at de kan redusere kolesterolnivåene hos kvinner. Epler kan både virke slankende, og kutte det dårlige kolesterolet i blodet, ifølge DailyMail.

De fant ut at kvinner som spiste 75 gram tørket eple om dagen i seks måneder fikk redusert det dårlige kolesterolet i blodet med 25 prosent. Det er gode nyheter for tilstoppede blodårer. (...)

Kolesterol – hvornår er forebyggende behandling med statin indiceret?
irf.dk 10.4.2011 (Institut for Rationel Farmakoterapi (IRF)
Det er værdierne kun, såfremt analysesvar ligger udenfor normalværdierne/referenceværdierne. Og disse normalværdier skal efter vores mening selvfølgelig anføres i prøvesvarene.

Når man indsender en blodprøve til analyse, vil resultatet sædvanligvis blive efterfulgt af et referenceinterval i parentes. Referenceintervallet eller normalområdet indeholder 95 % af raske personers værdier. (...)

Advarer mot kolesterolhysteri
aftenposten.no 8.4.2011
Ber fastlegene nekte å ta målinger

Friske eldre spiser kolesterolsenkende medisiner som aldri før. Leger mener mange blir skremt til å ta medisiner de ikke har bruk for.

Svært mange mennesker er redd for høyt kolesterolnivå og ber legene måle nivået. – Fastleger burde ha nektet å måle kolesterolet når folk er blitt rundt 65 år, om de ikke er i en risikogruppe, sier Ottar Nygård, professor ved institutt for indremedisin ved Haukeland Universitetssykehus.

– Det er meningsløst hvis alle skal sjekke kolesterolet. Det er ikke nødvendig. Vi vet blant annet at høyt kolesterol alene ikke er noen risikofaktor hos hjertefriske som har passert 65 år, sier Espen Rostrup, lege ved Hjerteavdelingen på Haukeland Universitetssykehus.

– Norske studier har vist at det er altfor mange friske, eldre som spiser kolesterolsenkende medisiner og tror at det forlenger livet deres. Det er en misforståelse som skremmer de eldre til å spise disse medisinene, sier Nygård. (...)

Blodet sladrer i kodesprog om sygdom
b.dk 27.2.2011
Ny dansk forskning peger på et overset tal, der måske kunne redde førlighed og liv.

Det er ikke ét fedt, hvordan vi bruger den test af fedtstoffer i blodet, der kan forudsige risiko for blodpropper, og som de fleste af os jævnligt går til lægen efter, fra vi rammer midalderen.

Lægerne har f.eks. længe undret sig over, at der ikke er en klar sammenhæng mellem forhøjet kolesterol i blodprøven og blodprop i hjernen, selv om kolesterolsænkende medicin klart sænker risikoen for at få et slagtilfælde.

Nu peger dansk forskning på, at gådens løsning ligger i triglyceriderne, som er det tal, vi sædvanligvis ignorerer i blodprøverne. (...)

- Kolesterol farligst for menn
nrk.no 24.2.2011
Høyt kolesterol øker risikoen for hjerneslag hos menn, mens kvinner må passe seg for fettstoffene triglycerider. Heldigvis hjelper fysisk aktivitet på begge deler.

Kolesterolnivået har lite å si for hjerneslag hos kvinner, ifølge ny dansk forskning. (...)

Studien er publisert i tidsskriftet Annals of Neurology. (...)

- For mange tar kolesterolmedisin
nrk.no 20.1.2011
Bivirkningene kan være verre enn gevinsten, ifølge en ny studie.

Rundt 400.000 nordmenn bruker medisiner mot høyt kolesterol, også kjent som «statiner».

Høyt kolesterol er en risikofaktor for hjerte/karsykdommer, og det blir derfor ansett som viktig å få ned kolesterolverdiene.

Men ifølge en ny metastudie fra det anerkjente Cochrane Library, mangler det vitenskapelige bevis for at slike medisiner reduserer risikoen for å dø av hjerte/karsykdommer - med mindre man har påvist hjerte/karlidelser.

Forskerne har gjennomgått 14 publiserte studier med tilsammen 34.272 deltakere. (...)

(Anm: Statins for the primary prevention of cardiovascular disease (Review) (The Cochrane Library 2011, Issue 1).)

Analys ifrågasätter preventiv behandling med statiner
lakemedelsvarlden.se 19.1.2011
Det finns idag inte något bevis för att patienter utan tidigare historia av hjärtkärlsjukdom ska behandlas med statiner. Det är slutsatsen i en Cochrane-översikt.

Forskarna från Cochrane Heart Group har i en systematisk översikt gått igenom 14 studier med totalt drygt 34 000 patienter som behandlats med statiner i preventivt syfte, färre än 10 procent av patienterna hade en historia av hjärtkärlsjukdom.

Cochraneforskarnas slutsats är att mycket lite talar för att det är kostnadseffektivt att som primärprevention behandla patienter med statiner. Resultatet av översikten, i vilken man kombinerade data från åtta studier av studierna med totalt 28 000 patienter, är att statiner i den här gruppen minskar risken att dö från nio till åtta per tusen personer som behandlas varje år. (...)

(Anm: Statins for the primary prevention of cardiovascular disease (Review) (The Cochrane Library 2011, Issue 1).)

Statins may raise stroke risk in some: study (Statiner kan ifølge studie øke risiko for hjerneslag hos enkelte)
reuters.com 10.1.2011
(Reuters) - People who have had a type of stroke caused by bleeding in the brain should avoid taking cholesterol-lowering drugs known as statins, U.S. researchers said on Monday.

Although statins are commonly used to prevent heart attacks and strokes, they said the drugs could increase the risks of a second stroke in these patients, outweighing any other heart benefits from the drugs.

"Our analysis indicates that in settings of high recurrent intracerebral hemorrhage risk, avoiding statin therapy may be preferred," Dr. Brandon Westover of Massachusetts General Hospital and Harvard Medical School and colleagues wrote in the Archives of Neurology. (...)

Læger slår alarm: Ny 'ond kolesterol' truer
bt.dk 2.8.2010
Farligt blodfedt er en bombe under din sundhed

Lægelige eksperter efterlyser langt mere fokus på blodfedtet triglycerid, der anses for endnu farligere end det såkaldt onde kolesterol.

En række førende eksperter advarer nu om, at den farligste type kolesterol er helt overset, selv om hver fjerde dansker er i farezonen.

B.T. skriver, at mange læger overser det andet blodfedt, triglycerid, der indeholder en anden type kolesterol, som er endnu farligere end det, vi i dag kalder det onde kolesterol. (...)

Statins and All-Cause Mortality in High-Risk Primary Prevention (Statiner og dødelighet av alle årsaker i høyrisiko primær forebygging)
Arch Intern Med. 2010;170(12):1024-1031 (June 28)
Background Statins have been shown to reduce the risk of all-cause mortality among individuals with clinical history of coronary heart disease. However, it remains uncertain whether statins have similar mortality benefit in a high-risk primary prevention setting. (...)

(Konklusjon Disse litteraturbaserte metaanalyser fant ingen bevis for nytte av statinterapi på alle årsaker til død innen høyrisiko primær forebygging.) (...) (Conclusion This literature-based meta-analysis did not find evidence for the benefit of statin therapy on all-cause mortality in a high-risk primary prevention set-up.)

(Anm: Hva er forebygging? (forebygging.no).)

Sjukdomar kopplas till statiner – men fördelarna överväger
dagensmedicin.se 21.5.2010
(...) Forskarna har analyserat data från en stor primärvårdsdatabas med mer än 2 miljoner patienter från England och Wales, varav runt 225 000 nyligen hade inlett behandling med statiner. Patienterna följdes under perioden januari 2002 till juni 2008.

Forskarna konstaterar att statinanvändning ökade risken för grå starr, muskelsjukdom, akut njursvikt och förhöjda levervärden. De tre sistnämnda tillstånden är sedan tidigare kända biverkningar av statiner. (...)

Riskökningarna gällde då forskarna kontrollerade för faktorer som ålder, rökstatus och andra sjukdomar.

På den positiva sidan fann forskarna att statiner tycktes skydda mot matstrupscancer och – som väntat – mot hjärt-kärlsjukdom. (...)

Cholesterol drug side effects need watching: study (Det er behov for å overvåke kolesterollegemidlers sideeffekter)
reuters.com 20.5.2010
(Reuters) - People using cholesterol-lowering statins have a higher risks of liver dysfunction, kidney failure, muscle weakness and cataracts and such side effects of the drug should be closely tracked, doctors said on Friday. (...)

The findings, published in the British Medical Journal, are unlikely to affect the use of best-selling medicines like Pfizer's Lipitor and AstraZeneca's Crestor, but the study's authors said patients taking statins should be "proactively monitored" for side effects. (...)

(Anm: Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database. BMJ 2010;340:c2197 (20 May).)

(Anm: Autoimmune attack underlying kidney failure. Interstitial nephritis, a common cause of kidney failure, has a complex and largely unknown pathogenesis. In a new published paper in The Journal of the American Society of Nephrology, a team of researchers led from Karolinska Institutet shows how interstitial nephritis can develop from an autoimmune attack on the kidney's collecting duct. (medicalnewstoday.com 24.3.2016).)

Unintended effects of statins in men and women in England and Wales: population based cohort study using the QResearch database (Uønskede effekter av statiner hos menn og kvinner i i England og Wales befolkningbasert kohortstudie ved bruk av QResearch databasen)
BMJ 2010;340:c2197 (20 May)
(...) Conclusions Claims of unintended benefits of statins, except for oesophageal cancer, remain unsubstantiated, although potential adverse effects at population level were confirmed and quantified. Further studies are needed to develop utilities to individualise the risks so that patients at highest risk of adverse events can be monitored closely. (...)

(Anm: Infra-red light to detect early signs of oesophageal cancer. Scientists have developed an endoscope that uses near-infrared light to spot early warning signs of oesophageal - food pipe - cancer, according to research published in the Journal of Biomedical Optics.  (medicalnewstoday.com 8.9.2016).)

Risks Seen in Cholesterol Drug Use in Healthy People (Risiko registrert ved bruk av kolesterollegemidler hos friske mennesker)
nytimes.com 31.3.2010
With the government’s blessing, a drug giant is about to expand the market for its blockbuster cholesterol medication Crestor to a new category of customers: as a preventive measure for millions of people who do not have cholesterol problems.

Some medical experts question whether this is a healthy move.

They point to mounting concern that cholesterol medications — known as statins and already the most widely prescribed drugs in the United States — may not be as safe a preventive medicine as previously believed for people who are at low risk of heart attacks or strokes. (...)

But for healthy people who would take statins largely as prevention — which would be the case for the new category of Crestor patients — other experts suggest the benefits may not outweigh any side effects. (...)

Simvastatin gitt i høyeste dose 80 mg gir økt bivirkningsrisiko
legemiddelverket.no 26.3.2010
USAs Food and Drug Administration (FDA) advarer om at simvastatin gitt i høyeste dose øker risiko for muskelbivirkninger. Legemiddelverket ønsker å minne om at risikoen for bivirkninger øker ved de høyeste dosene for alle statiner. Den nye studien viser en mulig økning ved bruk av 80 mg simvastatin, men nytten ansees fremdeles å være større enn risikoen.

Rhabdomyolyse er en meget sjelden muskelbivirkning som er rapportert ved bruk av alle statiner. I 2009 fikk totalt 356.615 personer utlevert simvastatin fra norske apotek, hvorav 17.525 i dosen 80 mg. Samlet sett er risiko for bivirkninger relativt lav selv om høy dose gir høyere risiko for bivirkninger enn lavere doser.

(Anm: rhabdomyolysis ; rabdomyolyse, ødeleggelse av skjelettmuskulatur. Årsaker Rabdomyolyse sees ved kirurgisk skade, trykkskade på grunn av redusert bevissthet, iskemi (lokal blodmangel) på grunn av nedsatt sirkulasjon, etter kramper, og i forbindelse med hypertermi (overoppheting) og forgiftninger. (...) Kilde: Store norske leksikon.)

(Anm: rabdomyolyse; nedbryting eller oppløysing av tverrstripete muskulatur som gir auka innhald i serum av myoglobin og ymse muskelvevsenzym; kan stundom koma som skadeverknad ved bruk av glutetimid, amfetamin, salisylat, fencyclidin, teofyllamin eller andre medikament eller pga virussjukdommar, slangebit, sterk muskelrøyning m v; kan vera årsak til farleg hyperkalemi, kan gi nyresvikt pga myoglobinopphoping i nyrene; kan stundom skuldast mangel på carnitinpalmityltransferase, eit enzym i feittstoffskiftet; jf Meyer-Betz' sjukdom
EN rhabdomyolysis Kilde: Norsk medisinsk ordbok.)

Advarer mot kolesterolmedisin
nrk.no 24.3.2010
(...) Det amerikanske legemiddelverket advarer mot alvorlige bivirkninger ved bruk av en kolesterolmedisin som brukes av over 350.000 nordmenn.

Legemiddelet Simvastatin brukes for å senke kolesterolnivået i blodet og redusere faren for hjerteinfarkt.

En ny amerikansk undersøkelse viser at høye doser kan føre til muskelskader og, i sjeldne tilfeller, nyreskader som i verste fall kan være dødelige.

Amerikanske Food and Drug Administration (FDA) ber nå pasienter som tar en daglig dose på 80 milligram om å være ekstra oppmerksomme på symptomer på bivirkningene, skriver Daily Telegraph. (...)

Legemiddelverket har fortsatt ikke bestemt seg om de vil gå ut med nærmere informasjon eller en advarsel til norske pasienter. (...)

Statiner ger ökad diabetesrisk
lakemedelsvarlden.se 17.2.2010
Personer som behandlas med blodfettssänkande statiner har nio procents högre risk at drabbas av diabetes visar en brittisk studie. Resultaten visar att det är viktigt att följa patienter som behandlas med statiner och inte sätta in det slentrianmässigt. (...)

Cholesterol drugs up diabetes risk slightly: study
reuters.com 16.2.2010
LONDON (Reuters) - People on cholesterol-lowering statins are 9 percent more likely to develop diabetes, but this small absolute risk is outweighed by the drugs' heart-protecting properties, researchers said on Wednesday. (...)

(Anm: Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010 Feb 27;375(9716):735-42.)

Är kolesterol en riskfaktor?
LARS WERKÖ - Professor emeritus i invärtesmedicin, tidigare chef vid SBU, TORE SCHERSTÉN - Professor emeritus i kirurgi, tidigare sekreterare i Medicinska Forskningsrådet, RALF SUNDBERG - Docent i transplantationskirurgi
svd.se 14.7.2009
Gott – och skadligt? Slutsatserna i den senaste kolesterolforskningen är färgad av läkemedelföretagens sponsring, hävdar artikelförfattarna. Hypotesen om att kolesterol är farligt bör förkastas, säger de.

”FARLIGT” KOLESTEROL Flera vetenskapliga studier har visat att infarktpatienter har lägre kolesterolvärden än normalbefolkningen och att dödligheten dessutom är högre vid låga värden. Nu är det dags att förkasta hypotesen om sambandet mellan höga kolesterolnivåer och hjärtinfarkter och kanske också dags att utreda vad som lett till detta vetenskapliga haveri, skriver Lars Werkö, Tore Scherstén och Ralf Sundberg. (...)

Storforbrug af medicin blandt raske
politiken.dk 1.1.2009
Siden 2003 er salget af kolesterolsænkende medicin steget med 233 procent. Årsag: Raske mennesker sygeliggøres, vurderer eksperter. (...)

»I dag er anbefalingen et kolesteroltal under 5. Med den grænse har de fleste voksne et ’for højt’ kolesteroltal. Og derfor gør vi en stor del af befolkningen til patienter uden grund«, siger Mats Lindberg, læge og talsmand for netværket Læger Uden Sponsor. (...)

Bare et fåtall har nytte av statiner
TOR OLE KJELLEVAND, lege
aftenposten.no 22.8.2008
Erik Øie skriver 18. august at de som har et avvikende syn på effekten av kolesteroldempende statiner, gjør pasientene rådville. De vet ikke lenger om de skal ta statiner eller ikke. Hvis dere hadde fortalt pasientene hele sannheten om statinene, ville det ikke vært så mye tvil. (...)

Hvis du ikke har hjertesykdom, har statinene beviselig ingen effekt. Dette er slått fast av The Internatonal Society of Drug Bulletins. De hadde gått gjennom alle tilgjengelige vitenskapelige data. Dette anerkjente organet er imidlertid ikke sponset av noe legemiddelfirma og er vel kanskje ikke til å stole på, dr. Øie? (...)

Til beste for pasientene
ERIK ØIE, lege, dr.med., Asker
aftenposten.no 18.8.2008
(...) Kolesteroldebatten. Et søk på de mest brukte helsebibliotekene på internett viser noe helt annet. De store behandlingsstudiene med statiner er riktignok organisert og finansiert av legemiddelfirmaer, og dette skyldes ganske enkelt at det bare er legemiddelfirmaer som har økonomiske midler til å gjennomføre slike studier som koster flere hundre millioner kroner. (...)

Om å ta mannen og ikke ballen
Tor Ole Kjellevand, lege, Oslo
aftenposten.no 9.8.2008
Jeg blir igjen angrepet på grunn av min overbevisning i kolesteroldebatten. Denne gang av dr. Erik Øie. (...)

Til det vil jeg bare si at jeg har ikke mottatt en eneste krone av dette firmaet eller av andre vitamin- eller kosttilskuddsprodusenter, hverken i form av penger, reisetilskudd, forskningsstøtte eller noe annet. Ikke engang i form av gratis vitaminer. Dem kjøper jeg selv. Jeg håper dr. Øie kan si det samme når det gjelder hans forhold til legemiddelindustrien. (...)

Statiner minsker risikoen
aftenposten.no 6.8.2008
ERIK ØIE, lege, dr.med., Nesøya
Tor Ole Kjellevand har gjennom avisinnlegg og intervjuer argumentert for at det er en myte at kolesterol er farlig og at denne myten har fått leve videre fordi legemiddelindustrien tjener store penger på å selge kolesterolsenkende medisiner; de såkalte statinene. (...)

Denne interessekonflikten bør Aftenpostens lesere ha in mente når de leser innlegg fra Kjellevand. (...)

Kan svekke minnet
DAG VILJEN POLESZYNSKI, dr.philos., fagredaktør, Mat&helse
aftenposten.no 9.7.2008
Leder av Nasjonalforeningen for folkehelsen, John Kjekshus, hevder i Aftenposten 2. juli: "Kolesterolsenkende medikamenter (statiner) påvirker ikke hukommelsen".

Debatten om kolesterolmedisiner. Han har muligens glemt (eller ikke lest) litteraturen som klart dokumenterer at statiner ikke bare kan føre til kortvarig hukommelsestap, men også kan gi mange andre bivirkninger. (...)

Er jeg blitt glemsk av pillene jeg tar?
Leiv Ose, Seksjonsoverlege, Lipidklinikken, Medisinsk avdeling, Rikshospitalet
aftenposten.no 4.7.2008
Spurte Frid Ingulstad 28. juni. Er det en bivirkning av de nye kolesterolmedisinene (statiner) mange må ta? (...)

Av de millioner som spiser statiner i USA, er det rapportert om 60 med glemskhet uavhengig av type statin som er brukt. Glemskheten kom i løpet av to måneder hos halvparten av de 60 rapporterte pasientene. Glemskheten forsvant igjen hos 14 av de 25 som ble glemske når de stoppet med statin. (...)

Tallene over viser til mange individuelle lege/pasientrapporter, men placebokontrollerte studier hvor mer enn 24 000 pasienter har deltatt, har ikke kunnet vise noen påvirkning av glemskhet eller kognitive funksjoner. (...)

Farlige medisiner
Tor Ole Kjellevand, lege
aftenposten.no 3.7.2008
I Aftenposten 28. juni etterlyser Frid Ingulstad informasjon fra "landets fremste fagfolk" om en type kolesterolmedisin, statiner, kunne være årsak til hennes økende glemsomhet. (...)

Om statinene er årsak til at akkurat hun opplever at hun er mer glemsk, er vanskelig å svare på. Vi blir alle litt mer glemske med alderen. Når det gjelder om statiner kan forårsake økende glemsomhet, er det liten tvil om at så er tilfelle. Statinene senker det livsviktige kolesterolet som er en viktig byggesten i kroppen vår, særlig i hjernen. Mange pasienter som er satt på statin har opplevd denne effekten, men den blir oversett av legene fordi de "vet" at statinene er ufarlige.

Men hvorfor tar du i det hele tatt statiner? Det er ikke påvist at de gjør noen nytte hos kvinner overhodet. Høyt kolesterol er ikke farlig og skal ikke behandles. Statiner kan ha en viss effekt hos menn med etablert kransåresykdom. Ikke fordi de senker kolesterolet, men fordi de har mange andre effekter. Når jeg hører om diskusjonen blant dine venner, om at de har klart å senke sitt kolesterol med så og så mye, blir jeg bare trist. Her snakker vi om friske mennesker som er gjort til pasienter av en overivrig lege. (...)

Påvirker ikke hukommelsen
JOHN KJEKSHUS, professor emeritus, leder i Nasjonalforeningen for folkehelsen
aftenposten.no 2.7.2008
Frid Ingulstad er bekymret over sitt pillebruk i sin Signert- artikkel 28. juni. Kolesterolsenkende medikamenter (statiner) påvirker ikke hukommelsen. Den første store undersøkelsen med et kolesterolsenkende medikament, simvastatin, ble utført i Norge for snart 20 år siden. (...)

Skeptikerne henviser til meldinger om bivirkninger som benbrudd, selvmord, kreft og nedsatt hukommelse, dette skyldes tilfeldigheter. I vår og mange andre kontrollerte undersøkelser fant man tvert imot færre av de påståtte bivirkningene i gruppen som fikk statiner enn i gruppen som fikk inaktiv medisin (placebo). Statinene har meget få og beskjedne bivirkninger selv hos gamle og svake pasienter. (...)

Etter hvert som vi blir eldre, er det normalt at mange av oss glemmer ord og avtaler, men det er bare 10 prosent som blir demente. (...)

Blir jeg glemsk av pillene jeg tar?
FRID INGULSTAD, forfatter
aftenposten.no 28.6.2008
KOLESTEROL. Vi tar piller for så mangt. Jeg tar mot for høyt kolesterol. Men nå er jeg blitt fortalt at jeg kan bli glemsk av pillene. Er det virkelig sant, en medisin som tar hukommelsen? (...)

Drugs Alone Don't Lower Heart Disease Risks for Overweight Americans
healthfinder.gov 12.5.2008
Study finds signs of trouble show up even when statins, blood pressure meds are used.

SOURCES: Gregory L. Burke, M.D., professor and director, division of public health sciences, Wake Forest University, Winston-Salem, N.C.; Lona Sandon, M.Ed., RD, assistant professor, clinical nutrition, University of Texas Southwestern Medical Center, Dallas; May 12, 2008, Archives of Internal Medicine)

MONDAY, May 12 (HealthDay News) -- Daily doses of statins and blood pressure medications will not be enough to prevent heart disease among the ever-growing number of Baby Boomers who are overweight or obese, a new study suggests.

The simple truth, experts say, is that pounds must also be shed to keep cardiovascular trouble away.

"There is a debate out there about whether this generation is going to live as long as their parents, and the truth is they probably won't," said study author Dr. Gregory L. Burke, director of the division of public health sciences at Wake Forest University School of medicine in Winston-Salem, NC. (...)

In Denial
forbes.com 9.4.2008
The latest cholesterol mess shows how big pharma just can't seem to face up to bad results.

When questions first emerged about a small study testing their $5 billion cholesterol pills Zetia and Vytorin, Merck (nyse: MRK - news - people) and Schering-Plough (nyse: SGP - news - people) pooh-poohed its importance. "I don't know why this would have any impact on mainstream use," Schering Chief Executive Fred Hassan told analysts in January. But newly released results say that these two immensely lucrative drugs don't impede plaque buildup in arteries. The New England Journal of Medicine even published two editorials telling doctors to use them as a last resort (a conclusion Merck and Schering disputed vigorously; the study showed no safety problems). (...)

Kolesterol-faren en bløff?
dagbladet.no 31.3.2008
Oppsiktsvekkende studie om bestselger-medisin lagt fram på internasjonal hjertekongress. (...)

Den såkalte Enhance-undersøkelsen, som omfatter 720 personer med familiær hyperkolesterolemi skulle i første rekke teste en ny type blodfettsenkende medikament - Ezetrol - (som i USA selges i en kombinasjonen med simvastatin under navnet Vytorin)- og sammenligne dette med det 'gamle' kolesterolsenkende middelet simvastatin (originalproduktet heter Zocor). (...)

(Anm: Simvastatin with or without Ezetimibe in Familial Hypercholesterolemia. Published at www.nejm.org March 30, 2008 (10.1056/NEJMoa0800742).)

Vytorin Makes Merck And Schering Swoon
forbes.com 31.3.2008
(...) On Sunday, The New England Journal of Medicine released the full results of a study called ENHANCE that showed Vytorin was no more effective than the older Zocor. Vytorin is a $5.2 billion joint-venture cholesterol drug that combines Merck's Zocor with Merck/Schering-Plough drug Zetia. Zocor is available in a less-expensive generic form. (...)

Sector Snap: Cholesterol Drug Makers
forbes.com 31.3.2008
A flurry of positive and negative study data for cholesterol drugs pushed shares of Merck & Co. and Schering-Plough Corp. to record lows Monday, while Abbott Laboratories and AstraZeneca PLC shares caught a boost. (...)

Journal Issues Warning on Two Cholesterol Drugs
nytimes.com 30.3.2008
CHICAGO — Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday. (...)

Merck and Schering-Plough, the companies that make Vytorin and Zetia, said on Sunday that despite the results of the trial, they would continue to promote their medicines as first-line treatments for high cholesterol. (...)

Hårreisende påstand av overlege
aftenposten.no 5.9.2007
Uffe Ravnskov, dr.med., dosent Lund, Sverige
Dr. Leiv Oses påstand at en mann med arvelig høyt kolesterol (FH) har 85 % risiko for å få et hjerteinfarkt før han blir 60 år, har ingen basis i virkeligheten. (...)

Det er ikke det høye kolesterolnivået som er farlig. Risikoen for personer med FH er nemlig den samme eller større (!) med lett forhøyet kolesterol som med et som er 2-3 ganger høyere enn normalt. Den økte dødeligheten av hjerteinfarkt skyldes at noen med FH også arver forstyrrelser i koagulasjonssystemet, ikke at de har høyt kolesterol. (...)

Hvem skal vi tro på?
Margaretha Gøransson Hamrin, leder FH Norge
aftenposten.no 31.8.2007
Det ser ut til at røntgenlegen Tor Ole Kjellevand nå søker å posisjonere seg som en norsk kolesterolekspert. (...)

Så hvem skal folk flest og spesielt de som er i risikogruppen for hjertedød, velge å tro på? (...)

Bare én type kolesterol
TOR OLE KJELLEVAND - Tidligere overlege
aftenposten.no 24.8.2007
Jeg blir angrepet av lederen i foreningen for familiær hyperkolesterolemi (FH) i Norge i tirsdagsavisen. Skandale var ordet hun brukte.

Jeg har gjort noe utilgivelig, nemlig vært uenig i Lipidklinikkens og Rikshospitalets offisielle syn i kolesteroldebatten. (...)

Betegnelsen "godt" og "dårlig" kolesterol er altså noe som er funnet på av tilbederne av kolesterolmyten. (...)

Det er ingen sammenheng mellom kolesterolnivået hos FH-pasientene og insidensen av hjertedød. Altså, FH-pasienter med forholdsvis lavt kolesterol dør like ofte som de med skyhøyt kolesterol. Hvorfor, hvis kolesterolnivået skulle være det viktigste for å overleve?

Statinene har nok en viss beskyttende virkning hos pasienter med FH. Ikke på grunn av kolesterolsenkningen, men på grunn av alle de andre effektene statinene har. (...)

When 'Good' Cholesterol Goes Bad (Når "god" kolesterol blir dårlig)
healthfinder.gov 22.8.2007
(SOURCES: Jay Heinecke, M.D., professor, medicine, University of Washington, Seattle; Aug. 22, 2007, American Chemical Society annual meeting, Boston)
WEDNESDAY, Aug. 22 (HealthDay News) -- It looks like HDL, the "good" cholesterol that supposedly protects against cardiovascular disease, might have a harmful side. (...)

Inflammation is the major villain in the new picture. Arteries are not only blocked because of the gradual growth of plaque. Instead, there comes a moment when plaque ruptures, causing a clot to form and block blood flow, Heinecke said. Proteins called proteases play a major role in these ruptures. (...)

So, measuring blood levels of LDL and HDL cholesterol is not as predictive of cardiac risk, as has been assumed, Heinecke stressed. "Protein composition [in HDL cholesterol] may be a better handle on whether someone is at risk," he added. (...)

Kolesterol på liv eller død
aftenposten.no 21.8.2007
Margaretha Gøransson Hamrin Leder for FH-Norge, pasientorganisasjon for familiær hyperkolesterol
En skandale. At en overlege fra Rikshospitalet offentlig og i sjikanøse ordelag går ut mot Lipidklinikken, som er landets viktigste behandlingssenter for den arvelige genfeilen familiær hyperkolesterolemi (FH), er intet mindre enn en skandale som sykehuset må rydde opp i. (...)

- Gjør kolesterollegemidler noe godt?

Do Cholesterol Drugs Do Any Good? (Gjør kolesterollegemidler noe godt?)
businessweek.com 17.1.2008
Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated

Med unntak for høyrisiko hjertepasienter, tyder forskning på at nytten av statiner slik som Lipitor er overdrevet. (...) (Research suggests that, except among high-risk heart patients, the benefits of statins such as Lipitor are overstated)

Such drugs are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006. Half of that went to Pfizer (PFE) for its leading statin, Lipitor. (...)

- Forlenger det livet?

WELL
Great Drug, but Does It Prolong Life?

nytimes.com 29.1.2008
Statins are among the most prescribed drugs in the world, and there is no doubt that they work as advertised — that they lower not only cholesterol but also the risk for heart attack. (...)

Kaiser Daily Health Policy Report Highlights Scrutiny Over Benefit of Using Statins
kaisernetwork.org 29.1.2008
Prescription Drugs

Two newspapers on Tuesday reported on scrutiny of statin use and whether the drugs provide prolonged life or benefits to patients with high cholesterol. Summaries appear below.

New York Times: In the "fallout from the headline-making trial of Vytorin, a combination drug that was found to be no more effective than a simple statin in reducing arterial plaque, many people are asking a more fundamental question about statins in general: Do they prolong your life?" the Times reports. According to the Times, middle-aged men with cardiovascular disease were less likely to die if they were taking a statin compared to those taking a placebo. However, "many statin users don't have established heart disease; they simply have high cholesterol," and "there is little evidence, if any, that taking a statin will make a meaningful difference in how long" people without heart disease live, the Times reports. In addition, "critics say there's no evidence that statin users have a better quality of life than other people," according to the Times. Mark Ebell, a professor at the University of Georgia and deputy editor of the journal American Family Physician, said, "High-risk groups have a lot to gain" from taking statins, but "patients at low risk benefit very little, if at all. We end up overtreating a lot of patients" (Parker-Pope, New York Times, 1/29).

Philadelphia Inquirer: Cholesterol-lowering drugs have been shown to "reduce the risk of death, heart attack and other problems in patients with cardiovascular disease, but it is less clear that they help patients ... who don't yet have heart disease," the Inquirer reports. According to the Inquirer, two analyses of scientific literature have shown that between "200 and 250 people with high cholesterol but no known cardiovascular disease must take a statin daily for three to five years to prevent one death." However, a similar analysis that tracked patients for an average of more than six-and-a-half years found that if 68 patients with high cholesterol "followed a more careful diet, one death could be avoided," according to the Inquirer. The Inquirer reports, "Given the financial stakes -- cholesterol-lowering drugs generated $21.6 billion from U.S. sales in 2006 -- some wonder whether studies that question the benefits of the medications ever reach the public" (Goldstein, Philadelphia Inquirer, 1/29). (...)

- Undersøkelse viser at leger avviser pasienters klager om bivirkninger

Is Your Doctor in Denial? (Nekter din lege å erkjenne fakta?)
washingtonpost.com 28.8.2007
Undersøkelse viser at leger ofte avviser klager om legemidlers sideeffekter (Survey Finds Physicians Often Dismiss Complaints About Drugs' Side Effects)

Mange engstelige pasienter gir detaljopplysninger på nettforum og pratekanaler på internett om muskelsmerter og hukommelsestap, som de har erfart etter at de begynte med statiner for å senke sitt kolesterol. En ny studie antyder at disse mennesker kanskje har en god grunn til å søke en bekreftelse: Noen klager ville ellers gå upåaktet hen. (On many online message boards and Internet chat rooms, anxious patients share details about the muscle pain and memory loss they have noticed since they started taking statins to lower their cholesterol. A new study suggests these people may be seeking validation for good reason: Some of their complaints might otherwise be going unheard.)

Ifølge en undersøkelse av 650 pasienter publisert sist uke om legemiddelsikkerhet, et fagfellevurdert tidsskrift, ignorerer eller avviser leger ofte pasienters bekymringer om slike sideeffekter. Studien viser et reaksjonsmønster som også gjelder andre legemidler. (According to a survey of 650 patients published last week in Drug Safety, a peer-reviewed journal, doctors frequently ignored or dismissed patients' concerns about such side effects. The study suggests this pattern of reaction goes beyond statins to other drugs.)

Når leger ikke erkjenner pasienters symptomer som en sideeffekt av legemiddelet, er også pasienten utsatt for risiko. På grunn av at legen ikke fyller ut og sender en "bivirkningsrapport" til Food and Drug Administration, kan legemiddelkontrollen undervurdere problemet, og andre leger og pasienter antar at legemiddelet er tryggere enn det er. (When doctors fail to recognize a patient's symptoms as drug side effects, more than that patient's care is put at risk. Because the doctor makes no "adverse event report" to the Food and Drug Administration, the regulatory agency may underestimate the problem, and other doctors and patients may assume the drug is safer than it is.)

Forskerne ved University of California at San Diego gransket sideeffekter for statiner da ble oppmerksomme på problemet. (...) (Researchers from the University of California at San Diego had been investigating the side effects of statins when they noticed the problem.)

Jerry Avorn -- professor ved Harvard Medical School og forfatter av boken "Powerful Medicines: Nytte, risiko og kostnader for reseptbelagte legemidler" -- sa at "der er en skrekkelig underrapportering av sideeffekter," og legger til at 90 til 99% av "alvorlige sideeffekter ikke rapporteres av leger." (...) (Jerry Avorn -- a Harvard Medical School professor and author of the book "Powerful Medicines: The Benefits, Risks and Costs of Prescription Drugs" -- said that "there is horrendous underreporting of side effects," adding that 90% to 99% of "serious side effects are not reported by doctors.")

- På helsa løs?

På helsa løs
Kjetil Retterstøl overlege dr. med Lipidklinikken Rikshospitalet
Dagbladet 28.9.2005
NRKs Pulsredaksjon fremstår som en gjeng Fedonister snarere enn seriøse helseopplysere, skriver Kjetil Retterstøl. (...)

Usaklige personangrep
dagbladet.no 12.10.2005
Fedon Lindberg trekker seg som kostholdsekspert i Puls.

OVERLEGE KJETIL Retterstøl fra Lipidklinikken gikk i et debattinnlegg i Dagbladet av 28.9. til angrep på meg personlig og redaksjonen i NRK Puls med en rekke påstander. Bakgrunnen for angrepet var et innslag i NRK Puls den 19.9. om matens betydning for helsen. Da nevnte jeg at en stor sveitsisk metaanalyse tydet på at omega-3 fettsyrer, som finnes i fiskefett, så ut til å forebygge dødelighet av alle årsaker og av hjertesykdom spesielt, samt at det så ut til at omega-3 reduserte slik dødelighet mer enn statiner, de nye kolesterolsenkende og hjertesykdomforebyggende medikamenter.

Etter å ha forsøkt å tillegge meg meningsløse og fullstendig feilaktige kommersielle motiver bak min presentasjon av denne studien, sendte jeg et tilsvar som ble publisert den 2.10. i Dagbladet.

Helsejournalistikk - ikke reklame
dagbladet.no 2.10.2005
Egil Sundvor Prosjektsjef i NRK Fakta
OVERLEGE KJETIL RETTERSTØL ved Lipidklinikken hevder at NRKs «Puls»-redaksjon er «en gjeng fedonister snarere enn seriøse helseopplysere» i Dagbladet 28.09. Retterstøl anklager redaksjonen for å løpe Fedon Lindbergs ærend, og ikke journalistikkens.

Dessuten mener han at «Puls» er helt uten kildekritikk og at omtalen av det gode fettet er helseskadelig. (...)

- Statiner kan øke risiko for parkinsons sykdom

Cholesterol Drugs May Cause Parkinson's - Report (Legemidler mot høyt kolesterol kan forårsake Parkinsons sykdom)
newsmax.com 22.1.2007
WASHINGTON -- New research showing a strong link between Parkinson's disease and low levels of "bad" cholesterol are so worrying that U.S. researchers are launching a study to look into it.

The team at the University of North Carolina is planning clinical trials involving thousands of people to see whether statin drugs, which lower low density lipoprotein, or LDL, might actually cause Parkinson's in some people.

Other research has for several years suggested that people with abnormally low levels of LDL might be at higher risk of Parkinson's.

Xuemei Huang and colleagues found that patients with low levels of LDL cholesterol are at least three and a half times more likely to develop Parkinson's disease than those with higher LDL levels.

Writing in the journal Chemistry & Industry, they said they plan a bigger study of patients taking statins, the biggest-selling drugs in the world. (...)

(Anm: Simvastatin enhances human osteoblast proliferation involved in mitochondrial energy generation. Eur J Pharmacol. 2013 Jun 11 (mintankesmie.no).)

(Anm: Muskelsykdom (myopati) (nevro.legehandboka.no).)

(Anm: Mitochondria (mitokondrie) (mitokondriesykdommer) (mitokondrielle sykdommer). (mintankesmie.no).)

(Anm: Linking telomere loss and mitochondrial dysfunction in chronic disease. (…) Drawing a mechanistic connection between telomere function and mitochondria biology will provide a broader perspective for understanding the pathophysiology of diseases and their relation to the aging process, and may provide opportunities for new possible treatments. Front Biosci (Landmark Ed). 2017 Jan 1;22:117-127.)

(Anm: Extreme short and long telomeres linked to increased cancer risk (news-medical.net 5.4.2017).)

(Anm: Scientists discover master regulator of cellular aging. (…) "Telomeres represent the clock of a cell," said TSRI Associate Professor Eros Lazzerini Denchi, corresponding author of the new study, published online in the journal Science. "You are born with telomeres of a certain length, and every time a cell divides, it loses a little bit of the telomere. Once the telomere is too short, the cell cannot divide anymore." (medicalnewstoday.com 13.1.2017).)

(Anm: Betennelser endrer mitokondrier til giftige fabrikker. Å lære hvordan å kontrollere betennelser kan ha store implikasjoner for behandlingen av mange sykdommer. Banebrytende forskning oppdager hvordan makrofager endrer mitokondriene til giftige kjemisk-produserende betennelsespromotører. (Inflammation turns mitochondria into toxic factories. Learning how to control inflammation could have huge implications for the treatment of many diseases. Breaking research discovers how macrophages turn mitochondria into toxic chemical-producing inflammation-promoters.) (medicalnewstoday.com 25.9.2016).)

(Anm: Research may show new ways to repress inflammation at outset. (…) Professor Alexander Weber of the Interfaculty Institute of Cell Biology says the enzyme - Bruton's tyrosine kinase or BTK - is switched on when an inflammation occurs in the body, playing a key role in the inflammation's subsequent development. (medicinenet.com 21.2.2017).)

(Anm: Ørsmå mitokondrier spiller en svært stor rolle mht. menneskets evolusjon og sykdom (Tiny mitochondria play outsized role in human evolution and disease.) (medicalnewstoday.com 25.9.2015).)

(Anm: Understanding mitochondrial complex I assembly in health and disease. Biochim Biophys Acta. 2012 Jun;1817(6):851-62. Epub 2011 Sep 2.)

(Anm: Selective inhibition of deactivated mitochondrial complex I by biguanides. Biochemistry. 2015 Feb 26. [Epub ahead of print].)

Statins may not protect against Parkinson's after all, study finds
medicalnewstoday.com 20.2.2015
Previously, some studies have found that the cholesterol-lowering medications statins may offer protective benefits against Parkinson's disease. However, a new study led by researchers at Penn State College of Medicine and the National Institute of Environmental Health Sciences was unable to reproduce this association.

About 1 million people in the US are currently affected by Parkinson's disease. The causes of Parkinson's are unknown, but scientists know that damage to neurons that produce dopamine eventually results in the movement disorders characteristic of this neurodegenerative brain disease.

Xuemei Huang, professor of neurology and vice chair for research at Penn State College of Medicine, had found in previous research an association between high blood cholesterol levels and lower incidence of Parkinson's.

Despite Huang's findings being reproduced in some similar studies, evidence has been inconsistent. Some epidemiology studies had also reported an association between lowered Parkinson's incidence and use of statins, which lower levels of low-density lipoprotein (LDL) cholesterol.
However, whether or not statins were responsible for the lowered Parkinson's incidence was difficult to prove, as these studies did not account for cholesterol levels prior to the widespread use of statins in the US.

In the new study - published in the journal Movement Disorders - Huang attempted to test this association. To do this, his team looked at low blood cholesterol levels, medication history and Parkinson's symptoms among people who participated in the long-running Atherosclerosis Risk in Communities study.

From the analysis, the team confirmed its previous finding that high total cholesterol and LDL were associated with lower risk of Parkinson's.

Statins, however, did not appear to protect against the disease. What is more, the study found an increase in long-term risk of Parkinson's for users of statins.

Huang admits that the analysis of statin use and Parkinson's risk was based on a "fairly small number of cases," but argues that the preliminary data suggest statins do not protect against the disease. (…)

Stopping Cholesterol Drugs Linked to Parkinson’s? (Stans i medisinering med statiner (mot høyt kolesterol) linket til Parkinson?)
ivanhoe.com 26.7.2013
(Ivanhoe Newswire) –People who stop taking cholesterol-lowering drugs may be at an increased risk of obtaining Parkinson’s disease, according to a recent study at the National Taiwan University in Taipei.

The study involved more than 43,000 statin users. Researchers found that those who stopped taking fat-soluble statins- like atorvastatin and simvastatin- were 58 percent more likely to develop Parkinson’s disease than those who continued to take the drugs.

However, there was no association for water-soluble drugs, like rosuvastatin and pravastatin, which are less capable to cross the blood-brain barrier. (...)

(Anm: Discontinuation of statin therapy associates with Parkinson disease - A population-based study. Neurology 2013;81(5):410-416 (July 30 2013).)

Low cholesterol linked to Parkinson's risk in men
NEW YORK (Reuters Health) 29.9.2005
- Is it possible to have too low a level of cholesterol? A cholesterol profile that reduces the risk of heart disease may increase the risk for Parkinson's disease -- at least for men -- researchers report.

Going back several years, studies have uncovered associations between low cholesterol and suicide, stroke, depression, even violence. While the findings in most cases did not stand up to scrutiny, the suspicion remains that very low cholesterol might influence mental function.

Now, at the annual meeting the American Neurological Association held this week in San Diego, California, Dr. Xuemei Huang described a possible link to Parkinson's disease.

Huang and colleagues, from the University of North Carolina at Chapel Hill, measured the lipid levels of 124 Parkinson's patients and a group of 112 similar people free of Parkinson's disease. (...)

- Truer antistatintrenden liv?

(Anm: Is the 'Anti-Statin' Trend Threatening Lives? MONDAY, July 24, 2017 (HealthDay News) -- A wave of anti-science skepticism may put people with high cholesterol at risk if they're convinced to quit life-saving statin medications, heart experts warn. An "internet-driven cult" is attacking the safety and effectiveness of cholesterol-lowering statins, despite mounds of clinical trial data showing the drugs work and produce minimal side effects, said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic. (medicinenet.com 24.7.2017).)

(Anm: Interessekonflikter, bestikkelser og korrupsjon (mintankesmie.no).)

(Anm: Når er et synspunkt en interessekonflikt? (When is a point of view a conflict of interest?) BMJ 2016;355:i6194 (Published 23 November 2016).)

Diverse artikler

Nye «supermedisiner» på vei: – Vil revolusjonere kolesterolbehandling.
vg.no 14.6.2015
** Statens Legemiddelverk: – Svært lovende medikamenter
** Ny forskning: Reduserer kolesterolet med ytterligere 47,5 prosent
Nye medisiner, som ifølge norske leger vil medføre et paradigmeskifte innen kolesterolsenkende behandling, er nå på trappene. – Dette blir stort, sier forsker.

Over 500.000 nordmenn går på ulike former for kolesterolsenkende medisiner, såkalte statiner, ifølge tall fra Reseptregisteret.

Statinene påstås generelt å gi lite bivirkninger, men mellom ti og tyve prosent får milde, men ubehagelige muskelsmerter som følge av medisinen. Noen får også alvorlige – i verste fall dødelige – bivirkninger.

Nå er behandlingen av høyt kolesterol, som blant annet settes i sammenheng med hjertesykdom og hjerteinfarkt, i ferd med å gjennomgå en stor omveltning.

Les også: Advarer mot kolesterolmedisiner

I tillegg til statiner, har forskere nå funnet en ny type medisin som reduserer det farlige kolesterolet LDL, betraktelig. Medikamentene inneholder antistoffer som binder seg til PCSK9, et protein som gjør at blodet ikke renses tilstrekkelig for det skadelige kolesterolet, og nøytraliserer det. (…)

HÅPEFULL: Fagdirektør og hjertespesialist Steinar Madsen i Legemiddelverket (…)

Legemiddelverket: – Stor tro på disse medisinene
Statens Legemiddelverk ser med stor optimisme på de nye PCSK9-hemmerne.

– Vi er enige i at dette er svært lovende legemidler og har stor tro på disse medisinene. For å gi et bilde av hvor stort dette kan bli, så kan jeg si at 518.000 nordmenn i fjor fikk kolesterolsenkende medisiner, i hovedsak statiner, og at de nye hemmerne senker LDL-kolesterolet ytterligere, sier fagdirektør og hjertespesialist Steinar Madsen i Legemiddelverket. (…)

– Trenger enda flere studier
VIKTIG TILLEGG: Medisinsk sjef Are Helseth i LHL mener medisinene vil bli en viktig del av behandlingen for mange pasienter.

Selv om studier viser at hemmerne dramatisk reduserer LDL-kolesterol, gjenstår det fortsatt forskning for å bevise at dette faktisk vil medføre færre slag og hjerteinfarkt. (…)

(Anm: I’ve already written about how Eli Lilly’s inhibitor of cholesteryl ester transfer protein (CETP) did not work in the clinic. Now that the data from their failed trial have been published in the NEJM, though, it’s worth taking a look at a few graphs (first pointed out to me on Twitter by Sek Kathiresan. Shown are the effects of evacetrapib on HDL and LDL, and he’s right: if you’d seen these graphs ten years ago, you’d have said that you’re looking at a cardiovascular wonder drug for sure. LDL down 30%, HDL up 125% – what else do you want? Well, you want actual cardiovascular outcomes. And that’s where this graph comes in. 12,000 total patients for over two years, and this is what you get: nothing. You lose – good day, sir! Absolutely no change in CV events whatsoever. There is something that we don’t understand here, about the various effects of CETP inhibition, or the various types of HDL and LDL and their downstream effects, or about the influence of these two on cardiovascular health in general. (blogs.sciencemag.org 18.5.2017).)

Usikker langtidseffekt av nye diabetesmedisiner
dagensmedisin.no 3.4.2014
Effekten av nye blodssukkersenkende legemidler på blant annet dødelighet er dårlig dokumentert. Sammenlignet med eldre medisiner for type 2-diabetes, er langtidsvirkningene usikre.

Kunnskapssenteret har sammenstilt systematiske oversikter som har undersøkt effekten av nye blodsukkersenkende legemidler for pasienter med type 2-diabetes.

DPP-4-hemmere og GLP-1-analoger i kombinasjon med metformin er sammenlignet med sulfonylurea i kombinasjon med metformin.

De systematiske oversiktene som er inkludert i rapporten, kan ikke dokumentere at de nye legemidlene har effekt på død og på langtidseffekter som nyresvikt, blindhet, nerveskader og hjerte- og karsykdom, ifølge Kunnskapssenteret. (...)

(Anm: ”Tveksam nytta av nya kolesterol­sänkare”. Varför avbröts det kolesterolsänkande experimentet Fourier i förtid? frågar forskaren Uffe Ravnskov. Professor Peter M Nilsson säger i Dagens Medicin nr 12/17 att det viktigaste beskedet från det senaste kolesterolsänkande experimentet Fourier är att det ”en gång för alla begraver alla tvivel om LDL-kolesterolets skadliga roll i uppkomsten av hjärt-kärlsjukdom.” Men hur förklarar han att det var 444 som dog i behandlingsgruppen men endast 426 i kontrollgruppen? Och hur förklarar han att det var fler som dog av en hjärt-kärlsjukdom i behandlingsgruppen? (dagensmedicin.se 29.3.2017).)

(Anm: Emotsedd studie öppnar för PCSK9-hämmare. En absolut riskminskning för nya hjärt-kärlhändelser med 1,5 procentenheter efter två år. Det blev resultatet när patienter med etablerad aterosklerotisk sjukdom fick tilläggsbehandling med det nya kolesterolsänkande läkemedlet Repatha (evolocumab). (dagensmedicin.se 17.3.2017).)

(Anm: Association of Bile Duct and Gallbladder Diseases With the Use of Incretin-Based Drugs in Patients With Type 2 Diabetes Mellitus. (…) Conclusions and Relevance: The use of GLP-1 analogues was associated with an increased risk of bile duct and gallbladder disease. Physicians should be aware of this potential adverse event when prescribing these drugs.JAMA Intern Med. 2016 Aug 1. [Epub ahead of print].)

Selective serotonin reuptake inhibitor drug interactions in patients receiving statins.
J Clin Psychiatry. 2014 Feb;75(2):e95-9.
Elderly patients commonly receive statin drugs for the primary or secondary prevention of cardiovascular and cerebrovascular events. Elderly patients also commonly receive antidepressant drugs, usually selective serotonin reuptake inhibitors (SSRIs), for the treatment of depression, anxiety, or other conditions. SSRIs are associated with many pharmacokinetic drug interactions related to the inhibition of the cytochrome P450 (CYP) metabolic pathways. There is concern that drugs that inhibit statin metabolism can trigger statin adverse effects, especially myopathy (which can be potentially serious, if rhabdomyolysis occurs). However, a detailed literature review of statin metabolism and of SSRI effects on CYP enzymes suggests that escitalopram, citalopram, and paroxetine are almost certain to be safe with all statins, and rosuvastatin, pitavastatin, and pravastatin are almost certain to be safe with all SSRIs. Even though other SSRI-statin combinations may theoretically be associated with risks, the magnitude of the pharmacokinetic interaction is likely to be below the threshold for clinical significance. Risk, if at all, lies in combining fluvoxamine with atorvastatin, simvastatin, or lovastatin, and even this risk can be minimized by using lower statin doses and monitoring the patient. (...)

(Anm: rhabdomyolysis ; rabdomyolyse, ødeleggelse av skjelettmuskulatur. Årsaker Rabdomyolyse sees ved kirurgisk skade, trykkskade på grunn av redusert bevissthet, iskemi (lokal blodmangel) på grunn av nedsatt sirkulasjon, etter kramper, og i forbindelse med hypertermi (overoppheting) og forgiftninger. (...) Kilde: Store norske leksikon.)

FDA sætter kolesterolmedicin under luppen
medwatch.dk 10.3.2014
FDA vil have medicinalvirksomheder til at undersøge risikoen for såkaldte neurokognitive bivirkninger i forbindelse med de nye kolesterolnedsættende PCSK9-hæmmere.

De amerikanske sundhedsmyndigheder FDA har rettet et kritisk øje mod den nye klasse af kolesterolnedsættende lægemidler kendt som PCSK9-hæmmere. Det skriver Reuters.(...)

UPDATE 3-U.S. FDA probes cognitive impact of new cholesterol drugs
reuters.com 8.3.2014
(Reuters) - The U.S. Food and Drug Administration has asked Regeneron Pharmaceuticals Inc and Sanofi SA to assess potential neurocognitive side effects of their experimental cholesterol drug, Sanofi said in its annual report on Friday.

Amgen Inc, which is developing a similar drug, said it has also been in communication with the agency.

The FDA said it could not discuss specific development programs, but is "aware of concerns raised with neurocognitive adverse events and other lipid-lowering therapies, including statins, and as part of our oversight of new drug development, we are carefully monitoring these events."

The new drugs are part of an experimental class known as PCSK9 inhibitors designed to block a protein that maintains "bad" LDL cholesterol in the bloodstream.

"We have not seen a neurocognitive adverse signal in the alirocumab data," Dr. Michael Aberman, Regeneron's vice president for strategy and investor relations, said in a telephone interview.

He said the alirocumab trials have been overseen by independent safety monitors.

"What the FDA asked us to do we don't expect to be difficult or time consuming," Aberman added. (...)

Statins: new US guideline sparks controversy
Lancet 2013;382(9906):1680 (23 November 2013)
Statins reduce cholesterol and are prescribed to many millions of people in high-income countries—not only high-risk patients with familial hypercholesterolaemia, for example, but also for primary prevention of atherosclerotic cardiovascular disease. Adverse events such as statin-induced myopathy are rare, and statins are likely to have contributed to the substantial fall in cardiovascular events, including stroke, at population level in recent decades. (...)

Fler amerikaner kan få statiner
lakemedelsvarlden.se 14.11.2013
Nya amerikanska riktlinjer kan leda till att dubbelt så många får behandling med statiner. Det kan gynna Astrazenecas Crestor.

Det amerikanska hjärtläkarsällskapet, American Heart Association, har publicerat nya riktlinjer för behandling med kolesterolsänkande medel. Antalet patienter som bör behandlas med statiner kan öka från 15 till 30 procent, skriver PharmaTimes.

De nya riktlinjerna innebär att man inte längre fokuserar på ett målvärde för LDL, utan istället identifierar de patientgrupper som har mest nytta av behandlingen. De grupperna är patienter med hjärt-kärlsjukdom, patienter med nivåer av LDL högre än 1,9 mmol/l, patienter mellan 45-70 år med typ 2-diabetes och patienter med en uppskattad tioårsrisk för hjärt-kärlsjukdom som är över 7,5 procent.

Förändringen kan innebära att 33 miljoner amerikaner kommer att rekommenderas statinbehandling, vilket är dubbelt så många som idag. Riktlinjerna kan innebära att högpotenta statiner som atorvastatin, simvastatin eller rosuvastatin används mer. De flesta har förlorat sitt patent, men patentet för Crestor (rosuvastatin) går ut under 2016. FiercePharma menar att Astrazeneca kan använda riktlinjerna för att öka försäljningen av Crestor innan patentet går ut. De nya riktlinjerna kommer troligtvis även att missgynna nya kolesterolsänkande läkemedel som inte är enbart statiner.

Riktlinjerna är framtagna utifrån publicerade studier mellan 1990 och 2012. (...)

Blodtryckskombo var dåligt för njurarna
dagensmedicin.se 9.11.2013
En kombination av blodtryckläkemedel av typen ARB och ACE-hämmare ökade risken för njurskador hos diabetespatienter med redan nedsatt njurfunktion, enligt en ny studie i New England Journal of Medicine.

Läkemedel som påverkar det så kallade renin-angiotensinsystemet kan bromsa försämringen av njurfunktion hos patienter med högt blodtryck.

Nu har forskare i USA undersökt om en kombination av sådana läkemedel ytterligare kan bromsa denna försämring. Svaret blev alltså nej. (...)

(Anm: Calcium-Channel Blocker–Clarithromycin Drug Interactions and Acute Kidney Injury (JAMA 2013 (Published online November 09).)

(Anm: Editorials. Cardiovascular risks associated with clarithromycin. A growing literature suggests these risks are not negligible. Concerns about the cardiovascular risks of macrolide antibiotics surfaced in the 1980s, with case reports and clinical studies describing arrhythmias and QT prolongation with erythromycin. BMJ 2016;352:i23  (Published 14 January 2016).)

(Anm: FDA: Andre studier modsiger danskernes studier. Der findes ikke entydige konklusioner om overdødelighed ved brug af antibiotikummet clarithromycin, mener de amerikanske sundhedsmyndigheder, FDA. (dagpharmatimes.com 21.10.2015).)

Calcium-Channel Blocker–Clarithromycin Drug Interactions and Acute Kidney Injury
JAMA 2013 ( Published online November 09)
Importance Calcium-channel blockers are metabolized by the cytochrome P450 3A4 (CYP3A4; EC 1.14.13.97) enzyme. Blood concentrations of these drugs may rise to harmful levels when CYP3A4 activity is inhibited. Clarithromycin is an inhibitor of CYP3A4 and azithromycin is not, which makes comparisons between these 2 macrolide antibiotics useful in assessing clinically important drug interactions.

Objective To characterize the risk of acute adverse events following coprescription of clarithromycin compared with azithromycin in older adults taking a calcium-channel blocker. (...)

Conclusions and Relevance Among older adults taking a calcium-channel blocker, concurrent use of clarithromycin compared with azithromycin was associated with a small but statistically significant greater 30-day risk of hospitalization with acute kidney injury. These findings support current safety warnings regarding concurrent use of CYP3A4 inhibitors and calcium-channel blockers. (...)

(Anm: Commonly prescribed antibiotic 'could increase risk of cardiac death' (medicalnewstoday.com 20.8.2014).)

Mener kolesterolmedisiner kan forebygge demens
vg.no 4.10.2013
Gladmelding til 500.000 nordmenn

Norske eksperter: Gir trolig gunstig effekt

POSITIVE: Både professor Dag Årsland som er ekspert på demens og hjerteprofessor Torbjørn Omland omtaler den amerikanske studien som grundig og interessant.

En halv million nordmenn får medisiner mot høyt kolesterol. Nå mener amerikanske forskere å ha funnet en klar sammenheng mellom legemiddelbruken og forebygging av demens.

Resultatene av studien som først ble publisert på Mayo Clinic sine nettsider, har sammenlignet en rekke studier på statiner og effekten på kognitiv svikt i hjernen.

Metastudien involverte totalt over 23.000 pasienter som ble fulgt i opptil 25 år.

Bakgrunnen er at de amerikanske legemiddelmyndighetene fra i fjor vedtok at statiner skulle merkes at de kunne føre til tap av hukommelse ved korttidsbruk.

I den norske Felleskatalogen for legemidler, er dette kun nevnt som svært sjeldne bvivirkninger.

Men den omfattende studien fra John Hopkins-sykehuset, fant ingen slik sammenheng ved korttidsbruk. I stedet fant de en forebyggende eller beskyttende effekt hos pasienter som hadde brukt medisinene over mange år.

Det er godt nytt for mange nordmenn. Tall fra Norsk reseptregister viser at det i fjor ble skrevet ut 487.000 på ulike statiner i Norge.

Legemiddelverket har tidligere gått ut og advart mot at mange eldre går på kolesterolmedisiner uten at det er nødvendig. (...)

(Anm: Statiner forebygger trolig ikke demens. (…) Hos personer med vaskulære risikofaktorer, som høyt blodtrykk og hjertesykdom, vil statiner trolig ikke forebygge demens og har trolig liten eller ingen effekt på kognitiv funksjonsevne. Det viser en Cochrane-oversikt. (kunnskapssenteret.no 11.3.2016).)

A Trial-Based Approach to Statin Guidelines
JAMA. 2013 (Published online August 12, 2013)
When the last set of US lipid-lowering guidelines was updated in 2004,1 placebo-controlled trials had proven statin therapy to be effective for the secondary prevention of cardiovascular disease. At that time, the ability of these agents to reduce rates of vascular events in primary prevention remained controversial, long-term safety with regard to cancer was unclear, and pharmacologic therapy was relatively expensive. (...)

Statiner forbundet med muskellidelser
dagenspharma.dk 20.6.2013
Personer i kolesterolsænkede behandling havde knap 20 pct. forøget risiko for at have muskel- og knogleproblemer. (...)

Certain Antibiotics Increase Muscle and Kidney Risk Among Older Statin Users
JAMA 201? (text)
Certain antibiotics may have a harmful interaction with statins in older adults.

A drug interaction between some statins and certain antibiotics puts older adults taking them concurrently at an increased risk for hospitalization and death, according to a study published today in the Annals of Internal Medicine. (...)

(Anm: Statin Toxicity From Macrolide Antibiotic Coprescription: A Population-Based Cohort Study. Ann Intern Med. 2013;158(12):869-876 (18 June 2013).)

Ha valnøtter i frokostblandingen, salaten eller brødet
kk.no 14.5.2013
SUNN FROKOST: Med litt valnøtter i frokosten, gjør du den mye mer næringsrik.

Kan senke det dårlige kolesterolet på få timer.

Vi vet alle at et sunt kosthold er svært viktig. Da er det ganske så fantastisk at det finnes noen matvarer som hjelper på så og si alt.

For eksempel kan noen valnøtter hver dag gjøre underverker for helsen din.

Forskere ved Universitetet i Pennsylvania har funnet ut at valnøtter har flere uante helsefordeler, og de er i tillegg lekende lett å innføre i kostholdet (Les mer om studien her!).

Resultater etter bare fire timer
Tar du bare en neve med valnøtter om dagen, beskytter det deg mot blant annet hjertesykdom.

Daily Mail skriver at det kan senke stressnivået, og dermed senke kolesterolnivået. Nøttene skal også gjøre at blodet flyter lettere gjennom årene dine. (...)

(Anm: Can a handful of walnuts a day keep the doctor away? (…) Walnuts also contain particularly high amounts of magnesium (163% of the recommended daily allowance in 100 g of walnuts), vitamin E and B vitamins. (medicalnewstoday.com 24.11.2015).)

(Anm: Walnuts may contribute to better health by changing makeup of gut bacteria. (news-medical.net 4.8.2017).)

(Anm: Ny studie: En håndfull nøtter om dagen kan redde liv. (…) Du kan redusere risikoen for hjertesykdommer med nesten 30 prosent bare ved å spise noen nøtter om dagen. (…) For eksempel kan 20 gram nøtter om dagen redusere risikoen for hjertesykdommer i Norge med over 16 prosent. (…) Peanøtter er egentlig en belgfrukt, mens de andre typene med nøtter (cashew, pistasj, hassel, valnøtter, mandler og pekannøtter) er såkalte trenøtter. (aftenposten.no 6.12.2016).)

(Anm: It’s good to eat walnuts, but is it true that they prevent heart disease? The excitement at the Express came from the abstract of a study on walnuts and health ageing, presented recently at a conference in San Diego. (…) Much too early to say  (…) Who funded the research? The source of funding for a research study is always worth looking at, in case the funders have vested interests in the results, and this study was supported by the California Walnut Commission. (theconversation.com 7.4.2016).)

Læger griber hurtigt til at ordinere statiner
dagenspharma.dk 11.4.2013
Undersøgelse tyder på, at læger ofte iværksætter statinbehandling hos patienter, der kun har begrænset eller ingen gavn af medicinen. (...)

The side effects of statin ads
worldpharmanews.com 8.3.2013
Television advertising may drive over-diagnosis of high cholesterol and over-treatment with statins, according to a new study by Dr. Jeff Niederdeppe from Cornell University in the US and colleagues. It appears that a trip to the doctor enquiring about statins advertised on TV often leads to a prescription. The work appears online in the Journal of General Internal Medicine, published by Springer. (...)

TV Ads for Statins May Drive Overtreatment
news.health.com 8.3.2013
FRIDAY, March 8 (HealthDay News) — Television ads for cholesterol-lowering statin drugs may lead to overdiagnosis of high cholesterol and overtreatment with the drugs, according to a new study.

The research found that patients’ visits with doctors to ask about statins advertised on TV often lead to prescriptions for the drugs.

The ads tell viewers about the health risks of high cholesterol and encourage them to seek medical advice, tests and appropriate treatment. The researchers wanted to assess the effect of this direct-to-consumer advertising.

The study was published online March 7 in the Journal of General Internal Medicine. (...)

“Our findings raise questions about the extent to which direct-to-consumer advertising may promote overdiagnosis and overtreatment for populations where risks may outweigh potential benefits,” wrote Dr. Jeff Niederdeppe, of Cornell University, and colleagues. “In addition, we found no evidence of favorable associations between exposure to statins in television advertisements and statin use among those at high risk for future cardiac events.” (...)

Trodde statiner økte selvmordsfaren
dagensmedisin.no 12.2.2013
I 1990 ble statinbehandling for å senke kolesterolet betegnet som dødelig behandling med økt risiko for selvmord, voldelig atferd og kreft, forteller den norske professoren bak den kjente 4S-studien.

- Det å senke kolesterolinnholdet i blodet var en av de mest kontroversielle problemstillingene i det 20. århundre, sier UiO- professor Terje R. Pedersen.

Et statingjennombrudd
Pedersen, som er professor ved Oslo universitetssykehus Ullevål var initiativtaker til og ledet den store Scandinavian Simvastatin Survival Study, mest kjent som 4S-studien. Studien bidro til et internasjonalt gjennombrudd for forståelsen av kolesterol som risikofaktor for hjerte- og karsykdom og effekten av behandling med statiner.

I dag behandles omkring en halv million i Norge med statiner. (...)

Pedersens statinforskning startet på Sarpsborg sykehus i 1977. Allerede i 1981 fikk Pedersen antatt en artikkel i New England Journal of Medicine. En randomisert placebokontrollert studie blant 253 pasienter viste nesten halvering av infarkt over tre år. Resultatene vakte internasjonal oppsikt.

- Aftenposten hadde ikke et ord om det, men det var oppslag i New York Times og over hele verden, sier Pedersen. (...)

Merck fjerner kolesterolmedicin fra markedet
medwatch.dk 14.1.2013
Et nyt studie viser, at en kolsterolmedicin fra medicinalgiganten Merck ikke er mere effektiv end andre såkaldte statiner på markedet. Derimod øger lægemidlet risikoen for alvorlige bivirkninger.

Mercks kolesterolmedicin, Tredaptive, som blev godkendt i Europa i 2008, bliver pt. markedsført i 70 forskellige lande, men nu ser det alligevel ud til, at lægemidlet har slået fejl. Det skriver PMLive.

Et nyt studie med navnet HPS2-THRIVE har nemlig vist, at behandling med Tredaptive i kombination med almindelig statin-terapi ikke førte til en nedsat risiko for at udvikle hjerteproblemer. Til gengæld havde patienterne i studiet en større risiko for at udvikle en række ikke-dødelige bivirkninger, såsom lymfesygdomme, mave-tarm lidelser og infektioner. (...)

Kolesterolmedel dras tillbaka
dagensmedicin.se 14.1.2013
Läkemedlet Tredaptive som används vid höga kolesterolvärden dras tillbaka efter att en ny studie har visat på biverkningar.

I en studie har MSD:s läkemedel Tredaptive uppvisat allvarliga, men inte livshotande biverkningar. Biverkningarna har bland annat drabbat blodet, lymfsystemet, magtarmkanalen och huden.

- Eftersom det inte är vi själva som gör studien, så vet vi ännu inte exakt vilka biverkningarna är. De svenska patienter som får Tredaptive bör nu kontakta sin läkare för att se vilken annan behandling de kan få, säger Ulf Janzon, pressansvarig för MSD i Sverige till TT.

Läkare uppmanas att inte skriva ut läkemedlet.

Treadaptive innehåller de aktiva substanserna nikotinsyra och laropiprant. (...)

Livsfarlig kolesterolsygdom overses
b.dk 31.10.2012
Der er en stærk sammenhæng mellem forhøjet kolesterol og åreforkalkning.

Fire gange flere danskere end antaget har arveligt forhøjet kolesterol, som hverken kan løbes eller slankes væk. Den livsfarlige sygdom opdages ikke og behandles derfor ikke. (...)

European Heart SCORE
irf.dk 26.10.2012 (Institut for Rationel Farmakoterapi (IRF)
Kort om studiet
European Heart SCORE (EHS) er en algoritme til beregning af hjerteraske patienters 10-årsrisiko for død af hjertekarsygdom ud fra køn, alder (40 til 65 år), systolisk blodtryk (SBT), total kolesterol (TK) og rygestatus.

Aktuelle studie rummer en matematisk modelanalyse. Algoritmen for EHS er ændret således, at behandleren også kan få et mål for patientens 10-årsrisiko for død af alle årsager, den forventede restlevetid og et groft skøn over effekten af statinbehandling (1).

Resultaterne præsenteres som tabeller til risikoscoring og tabeller over sammenhænge mellem risikostatus, forventet restlevetid og effekt af statinbehandling udtrykt som henholdsvis 10-års absolut risikoreduktion for død af alle årsager og gennemsnitlig levetidsforlængelse (2).

Et eksempel:

En 60-årig mandlig ikke-ryger med SBT 160 mmHg og TK 6 mmol/l har en 10-års risiko for død af hjertekarsygdom på 8,6 % og for død af alle årsager på 20,7 %. Hans forventede restlevetid er 19 år. Statinbehandling kan efter modellen forventes at reducere hans 10-årsrisiko for død med 0,9 % (fra 20,7% til 19,8 %, Numbers Needed to Treat, NNT = 111) og give en levetidsforlængelse på 5 måneder.

Analysen viser, at effekten af statiner svækkes i aldersgrupper over 55 år som følge af den aldersrelaterede stigning i dødelighed af andre årsager end hjertekarsygdom. (...)

People's Pharmacy: Statin interaction proved fatal
seattletimes.nwsource.com 23.9.2012
People's Pharmacy answers reader queries about a statin interaction that proved fatal; getting off Cymbalta; and a craving for ice. (...)

Q: Getting off Cymbalta is challenging but not impossible. I experienced lightheadedness, dizziness and "brain zaps." These felt like being able to hear my eyes move. It sounded like the lightsabers on "Star Wars" — very strange and disconcerting.

The key is to reduce the dosage very, very slowly. Take the capsules apart and begin by removing 5 or 10 of the tiny balls inside. Do this for a week or so, then slowly increase the amount you remove each week or two as you can tolerate it.

Your doctor may not be of any help. Mine wasn't. He instructed me to wean off over a two- to three-week period, and I almost lost my mind. I did it myself over a year or more.

A: We appreciate your detailed description of how you got off Cymbalta (duloxetine). The Food and Drug Administration does not require manufacturers of antidepressants such as citalopram, duloxetine, paroxetine, sertraline or venlafaxine to provide detailed instructions on gradual withdrawal. We think this is a serious oversight, since "discontinuation syndrome" is common and challenging. (...)

(Anm: Venlafaxine-Induced Cytotoxicity Towards Isolated Rat Hepatocytes Involves Oxidative Stress and Mitochondrial/Lysosomal Dysfunction. Purpose: Depression is a public disorder worldwide. Despite the widespread use of venlafaxine in the treatment of depression, it has been associated with the incidence of toxicities. Hence, the goal of the current investigation was to evaluate the mechanisms of venlafaxine-induced cell death in the model of the freshly isolated rat hepatocytes. (…) Conclusion: Therefore, our data indicate that venlafaxine induces oxidative stress towards hepatocytes and our findings provide evidence to propose that mitochondria and lysosomes are of the primary targets in venlafaxine-mediated cell damage. Adv Pharm Bull. 2016 Dec;6(4):521-530.)

(Anm: Akutt toksisitet for 8 antidepressiva: hva er deres virkningsmekanismer? (Acute toxicity of 8 antidepressants: what are their modes of action? Currently, the hazard posed by pharmaceutical residues is a major concern of ecotoxicology. Most of the antidepressants belong to a family named the Cationic Amphipathic Drugs known to have specific interactions with cell membranes. The present study assessed the impact of eight antidepressants belonging to selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors.) Chemosphere. 2014 Aug;108:314-9. Epub 2014 Feb 14. (PDF).)

(Anm: Cytotoxic immune cell in sick and healthy skin a key to understanding vitiligo. With the aid of thousands of skin biopsies and over a hundred kilograms of skin, researchers at Karolinska Institutet have observed how two subgroups of immune cell behave in healthy skin. This functional dichotomy is preserved in the inflammatory diseases psoriasis and vitiligo. The study, which is published in the journal Immunity, opens the way for more targeted local treatments for patchy inflammatory skin disorders. (medicalnewstoday.com 22.2.2017).)

Statin Use Tied to Possible Boost in Cataract Risk (Bruk av statiner knyttet til mulig øket risiko for katarakt)
consumer.healthday.com 24.8.2012
But link isn't proven and patients shouldn't stop taking cholesterol-lowering drugs, researchers say

FRIDAY, Aug. 24 (HealthDay News) -- The millions of adults who currently use prescription statins to control their cholesterol levels may be inadvertently increasing their risk for developing age-related cataracts, new research suggests.

The bump in cataract risk linked to statin use appears comparable to the elevated risk already known to exist among people with type 2 diabetes, the study team observed.

That said, the study authors cautioned that more research is needed before being able to definitively say there is a cause-and-effect relationship between statins and cataract risk.
"The bottom line is that there appears to be an increased risk among people taking statins as far as getting cataracts," said study lead author Elizabeth Irving, research chairwoman in the School of Optometry and Vision Science at the University of Waterloo in Ontario, Canada. "That was actually a surprise, because most of the previous literature had suggested the opposite. However, it doesn't mean that one is causing the other." (...)

Dansk studie: Nyt kolesterol giver blodpropper
bt.dk 26.7.2012
Nyt dansk studie viser, at forhøjede værdier af det nye kolesterol lipoprotein(a) nu direkte kan kobles sammen med åreforkalkning og blodpropper

Nyt dansk studie viser, at forhøjede værdier af det nye kolesterol lipoprotein(a) nu direkte kan kobles sammen med åreforkalkning og blodpropper

Hidtil har lægerne især fokuseret på LDL-kolesterolet som den store synder i forbindelse med blodpropper. Men efter at have tjekket blodet hos 40.000 danskere fastslår ny forskning, at den hidtil oversete kolesterol-type lipoprotein(a) er en hel selvstændig årsag til hjertekarsygdomme - uafhængigt af det kolesteroltal, som vi i dag får målt hos lægen.

Forskernes tal viser, at hver femte dansker har for høje værdier af den meget farlige form for kolesterol, lipoprotein(a) - de fleste uden at vide det.

Det danske forskerhold advarer derfor mod ikke for snævert kun at fokusere på LDL-kolesterolet, når lægerne ser efter danskere, der er i farezonen for at få blodpropper.

- Vores forskning viser, at forhøjede værdier af kolesterol-typen lipoprotein(a) nu direkte kan kobles sammen med en øget risiko for åreforkalkning og dermed blodpropper i hjertet og hjernen – og betyde for tidlig død. Det er derfor en meget vigtig markør, når vi skal finde folk, der er i farezonen for blodpropper, siger en af personerne bag undersøgelsen, professor ved Københavns Universitet og overlæge på Herlev Universitets Hospital, Børge Nordestgaard. (...)

Statin Intake Is Associated With Decreased Insulin Sensitivity During Cardiac Surgery
Diabetes Care 2012 (Published online before print July 24, 2012)
(...) OBJECTIVE Surgical trauma impairs intraoperative insulin sensitivity and is associated with postoperative adverse events. Recently, preprocedural statin therapy is recommended for patients with coronary artery disease. However, statin is reported to increase insulin resistance and the risk of new-onset diabetes. Thus, we investigated the association between preoperative statin therapy and intraoperative insulin sensitivity in nondiabetic, dyslipidemic patients undergoing coronary artery bypass grafting. (...)

CONCLUSIONS Preoperative use of lipophilic statins is associated with increased insulin resistance during cardiac surgery in nondiabetic, dyslipidemic patients. (...)

Doubt Cast on the ‘Good’ in ‘Good Cholesterol’
nytimes.com 16.5.2012
The name alone sounds so encouraging: HDL, the “good cholesterol.” The more of it in your blood, the lower your risk of heart disease. So bringing up HDL levels has got to be good for health.

Or so the theory went.

Now, a new study that makes use of powerful databases of genetic information has found that raising HDL levels may not make any difference to heart disease risk. People who inherit genes that give them naturally higher HDL levels throughout life have no less heart disease than those who inherit genes that give them slightly lower levels. If HDL were protective, those with genes causing higher levels should have had less heart disease.

Researchers not associated with the study, published online Wednesday in The Lancet, found the results compelling and disturbing. Companies are actively developing and testing drugs that raise HDL, although three recent studies of such treatments have failed. And patients with low HDL levels are often told to try to raise them by exercising or dieting or even by taking niacin, which raised HDL but failed to lower heart disease risk in a recent clinical trial. (...)

People's Pharmacy: Statins and memory loss
seattletimes.nwsource.com 15.1.2012
People's Pharmacy answers queries from readers about statins and memory loss; nitroglycerin patches for osteoporosis; and beta blockers contributing to cold hands and feet. (...)

Overvurderer statineffekten
dagensmedisin.no 30.12.2011
Et flertall av fastlegene overvurderer levetidsgevinsten ved statinbehandling.

Hele tre av fire allmennleger overvurderer betydningen av statinbehandling for en pasient i en gitt kasuistikk.

Dette fremgår av en studie som ble presentert på Nidaroskongressen i oktober av Peder A. Halvorsen ved Universitetet i Tromsø. Han er førsteforfatter av studien, og medforfattere er Olaf G. Aasland og Ivar Sønbø Kristiansen.

- Dette er en type effektmål som allmennleger ikke er så vant til å forholde seg til, så vi bør ikke trekke konklusjonen for langt. Det kan godt hende vi ville ha funnet samme tendens ved andre legemidler. Studien vår antyder i hvert fall et behov for at slike tall blir tilgjengelige og at legene læres opp i å bruke dem, sier Peder A. Halvorsen til Dagens Medisin.

Han er forsker ved Universitetet i Tromsø og fastlege ved Nordlys legesenter i Alta. (...)

The Heart Pill Debate
ivanhoe.com 19.12.2011
CLEVELAND, OH (Ivanhoe Newswire) -- A landmark study has changed how some cardiologists view a popular drug used to lower bad cholesterol. Some are now prescribing it to patients with normal cholesterol, but some doctors think it might do more harm than good. (...)

After less than two years the five year study was cut short because of those findings. Cleveland clinic cardiologist Steven Nissen says the study changed the way he practices medicine. He tells us before the results, he and a lot of other doctors occasionally did blood tests for inflammation.

“Well, we’re making that measurement more often now,” Dr. Nissen said.

Doctors may use the results to prescribe statins to prevent heart disease. But, University of California - San Diego, Dr. Beatrice Golomb says it is not known with longer term use and in real world users, whether the benefits outweigh the real risks.

“It's portrayed as being so fantastically safe it should be put in the water supply. The real world use this drug causes problems not infrequently,” Beatrice Alexandra Golomb, M.D., Ph.D., an, associate professor of medicine at the University of California - San Diego School of Medicine, said.

Golomb tells us while some people benefit from statins others have reported symptoms similar to Alzheimer’s. Muscle weakness, nerve damage, and cognitive problems have also been issues.

For people in the Jupiter study...

“There was evidence of a significant increase in incident diabetes,” Dr.Golomb said.

She wants to see more studies on the drug’s long term effects on patients with inflammation, but Dr. Nissen still believes in most of those cases statins work.

“It’s taken more to convince others and I respect people who are cautious,” Dr.Nissen said.

Dr.Golomb says she would like to see other, potentially safer, anti-inflammatory agents like low-dose aspirin tested to see if the effects are similar or even better than statins. As for people with normal cholesterol, other risk factors for heart disease inflammation blood tests are inexpensive and available at just about every hospital. (...)

Zocor (simvastatin) tablets
fda.gov (October 2011)
Detailed View: Safety Labeling Changes Approved By FDA Center for Drug Evaluation and Research (CDER) – November, March and April 2010, June and

WARNINGS AND PRECAUTIONS

Myopathy/Rhabdomyolysis
Zocor therapy should be discontinued if markedly ...
Amiodarone added to TABLE 1
Liver Dysfunction
There have been rare postmarketing reports of fatal and non-fatal hepatic failure in patients...
Endocrine Function
Increases in HbA1c and fasting serum glucose levels have been reported ... (...)

Statins and diabetes
Risk of diabetes from statins may be higher in women

BMJ 2011;343 (8 November)
In their editorial Byrne and Wild grapple with the “paradox that arises” when statins, targeted to lower cardiovascular risk, increase diabetes, one of the most potent cardiovascular risk factors.1 They suggest that statins reduce all cause mortality by citing a statistical exercise with questionable assumptions from which no long term effect (or numbers needed to treat) can be calculated for women.2

Indeed, no study or meta-analysis has shown that statins have a beneficial effect on all cause mortality in women.3

The pleiotropic effect of statins seems to underlie their diabetogenic action, while other pleiotropic actions also explain their benefit, primarily by promoting the nitric oxide-endothelial nitric oxide synthase pathway (mimicked by glyceryl trinitrate).4

In the JUPITER study, for example, which showed a 25% increase in the incidence of type 2 diabetes,5 the only benefit for women was the need for fewer revascularisation operations.6 Statins’ known effects on nitric oxide-endothelial nitric oxide synthase are likely to reduce angina symptoms and could explain the reduced need for revascularisation.

In women, therefore, the main or only cardiovascular benefit of statins may be a reduction in the symptoms of angina, while increasing diabetes by 25%. If so, the long term diabetogenic effects of statins do not support Byrne and Wild’s suggestion that the benefit for those at “moderate” risk outweighs potential harm. (...)

Cholesterol Level and Statin Use in Alzheimer Disease
Arch Neurol. 2011;68(10):1239-1244 (October )
During the last 2 decades, evidence has accumulated that a high cholesterol level may increase the risk of developing Alzheimer disease (AD). With the global use of statins to treat hypercholesterolemia, this finding has led to the anticipation that statins could prove useful in treating or preventing AD. However, the results of work on this topic are inconsistent: some studies find beneficial effects, but other studies do not. In this first segment of a 2-part review, we examine the complex preclinical and clinical literature on cholesterol level and AD. First, we review epidemiological research on cholesterol level and the risk of AD and discuss the relevance of discrepancies among studies with regard to participants' age and clinical status. Second, we assess studies correlating cholesterol level with neuropathological AD type. The potential molecular mechanisms for the apparent adverse effects of cholesterol on the development of AD are then discussed. Third, we review preclinical studies of statin use and AD. Therefore, this first part of our review provides the background and rationale for investigating statins as potential therapeutic agents in patients with AD, the subject of the second part. (...)

A randomized, double-blind, placebo-controlled trial of simvastatin to treat Alzheimer disease
Neurology. 2011 Aug 9;77(6):556-63. Epub 2011 Jul 27.
BACKGROUND: Lowering cholesterol is associated with reduced CNS amyloid deposition and increased dietary cholesterol increases amyloid accumulation in animal studies. Epidemiologic data suggest that use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) may decrease the risk of Alzheimer disease (AD) and a single-site trial suggested possible benefit in cognition with statin treatment in AD, supporting the hypothesis that statin therapy is useful in the treatment of AD. (...)

CONCLUSION: Simvastatin had no benefit on the progression of symptoms in individuals with mild to moderate AD despite significant lowering of cholesterol. (...)

Diabetesrisiko ved høye statindoser
dagensmedisin.no 22.8.2011
Høyeste anbefalte dose av statin er forbundet med økt risiko for diabetes, sammenlignet med moderat statindose.

Det fremgår av en metaanalyse som ble publisert i JAMA i sommer (David Reiss m.fl.) I alt fem tidligere studier inngår i analysen, som inkluderer over 32.700 personer. (...)

(Anm: Risk of Incident Diabetes With Intensive-Dose Compared With Moderate-Dose Statin Therapy. JAMA. 2011;305(24):2556-2564 (September 7).)

Astrazeneca shares fall on Crestor results
forbes.com 2.9.2011
Shares of AstraZeneca PLC fell Friday after a study meant to show its cholesterol drug Crestor was better at preventing plaque buildup in heart arteries than rival drug Lipitor found no clear advantage for its drug.

THE SPARK: The study compared Crestor with Pfizer Inc.'s Lipitor in high-risk patients with hardening of the arteries, a condition that can cause strokes or heart attacks. Astrazeneca said preliminary results indicated Crestor showed a greater percentage reduction in the volume of plaque in coronary arteries, the study's main goal. But the result was not statistically significant, meaning it could have occurred by chance. The study did produce a statistically significant reduction in a secondary goal, reduction of total plaque volume.

THE BACKGROUND: AstraZeneca was gambling that the study would show Crestor was better than Lipitor, the world's top-selling drug. That would have given the British drug maker a strong argument that doctors and patients shouldn't defect from Crestor to generic Lipitor when it becomes available on Nov. 30, offering big savings. (...)

Finding a Better Barometer of Heart Attack, Stroke Risk
JAMA 2011 (August 18)
Filed under: Cardiovascular System,Cardiovascular Disease/Myocardial Infarction,Stroke,Public Health,Cerebrovascular Disease — Rebecca Voelker @ 6:01 pm

Heart scans can detect coronary artery calcium (arrowhead), which is shown in a new study to better predict heart attack and stroke risk than C-reactive protein. (Image: Allen J. Taylor, MD/Washington Hospital Center)

Looking for calcium in the coronary arteries of people with normal levels of “bad” cholesterol is a more accurate way to predict their risk of having a heart attack or stroke than testing their blood for a marker of inflammation, according to a new study. The findings could help physicians fine-tune important decisions about which patients need cholesterol-lowering statin medications. (...)

Increased risk of glucose intolerance and type 2 diabetes with statins
BMJ 2011; 343:d5004 (8 August)
In people with a moderate or high risk of cardiovascular disease, benefits of statins still outweigh the risks

Statins are considered a 21st century panacea to the extent that some people propose they should be taken by everyone over 55 years of age.1 Convincing evidence shows that statins reduce all cause mortality and prevent or postpone cardiovascular disease,2 and that in general they are well tolerated, with 11 cases of myopathy (the most serious side effect) occurring per 100 000 person years of treatment.3 (...)

Despite uncertainties about the precise mechanisms responsible for reduced glucose tolerance with statins, clinicians should be reassured that, for most people at moderate or high risk of cardiovascular disease, the benefits of statins outweigh the risks. For every 1000 people treated with statins for secondary prevention for an average of 4.2 years, about 37 can expect to have a cardiovascular event prevented, and five can expect a serious adverse event (such as rhabdomyolysis or myopathy).11 The meta-analysis described above suggests that about four extra people for every 1000 treated with statins can be expected to develop diabetes compared with an untreated group.7 (...)

No clear link between statins and kidney cancer
reuters.com 29.7.2011

(Reuters Health) - The cholesterol-lowering statin drugs are not linked to an increased risk of kidney cancer, suggests a new study. But there also isn't enough evidence to say that they offer any protection against the disease, researchers say.

One in four adults age 45 and older in the U.S. takes a statin to lower cholesterol and protect against heart disease. Some researchers were concerned when the drugs first hit the market that they might up cancer risks.

So far, the evidence on such a link "has been all over the place," said study author Dr. Toni Choueiri, from Harvard Medical School in Boston.

For kidney cancer in particular, "you had studies that showed increased risk (and) studies that showed no association," he told Reuters Health. (...)

CT Scan Detects Silent CV Risk
medpagetoday.com 11.7.2011
Coronary calcium buildup detected by coronary artery CT scan was associated with an increased risk of heart attack or stroke even in asymptomatic patients with low LDL cholesterol, researchers found.

Calcium in the coronaries predicted a 4.23-fold risk of heart disease events in such patients (95% CI 2.28 to 7.86), Khurram Nasir, MD, MPH, of Yale University, and colleagues reported.

This effect was independent of traditional prognostic factors, suggesting incremental prognostic value, the group noted in the July 19 issue of the Journal of the American College of Cardiology. (...)

Statin interactions 'common' in GP prescribing
pulsetoday.co.uk 11.7.2011
GP co-prescribing of statins and interacting drugs is common in primary care, research suggests.

A study examining the co-prescribing of statins and CYP3A4 inhibitors – which is associated with an increased risk of adverse drug reactions – found 11% of patients in general practice were prescribed the two drug types concomitantly. (...)

Dr Ameet Bakhai, consultant in cardiology at Barnet Hospital in London, concluded: ‘Co-prescribing of CYP3A4-metabolised statins and CYP3A4 inhibitors is common in UK primary care. This co-prescribing suggests limited appreciation of potential interactions and MHRA safety advice, with the potential to increase the likelihood for side effects amongst patients despite the availability of suitable alternative agents for lowering cholesterol. Education should be targeted at prescribers and pharmacists in order to improve the situation.' (...)

Common drug combo increases diabetes risk (Vanlig kombinasjon av legemidler øker risikoen for diabetes)
newscientist 27.5.2011
A combination of two common drugs – one an antidepressant, the other used to lower blood cholesterol – may put people at risk of developing diabetes. This unexpected finding shows the benefits of data mining to discover hidden hazards lurking in our medicine cabinets.

Interactions between drugs can be hazardous or even fatal. When a particular combination of drugs is known to be dangerous a warning appears on the drugs' labelling, but there are many potential hazards that are not yet known about.

To look for drug combinations that might trigger diabetes, Nicholas Tatonetti and Russ Altman of Stanford University in California turned to a database called the Adverse Event Reporting System (AERS), run by the US Food and Drug Administration (FDA).

AERS contains reports from doctors whose patients have experienced drug side effects, but some researchers dismiss it as being too "noisy" to yield useful insights. One problem is that many adverse drug reactions never get reported. "There's a pretty big threshold for a physician to decide to submit a report to the FDA," Tatonetti explains.

And when a drug's hazards become well known, the database gets flooded with "me too" reports – for instance, AERS contains more than 70,000 reports about Vioxx, an anti-inflammatory painkiller that was withdrawn from sale in 2004 after being linked to deaths from heart attacks and stroke. (...)

(Anm: paroksetin (paroxetine); markesføres i Norge under handelsnavn som bl.a. Seroxat; Paxil i USA.)

(Anm: Detecting Drug Interactions From Adverse-Event Reports: Interaction Between Paroxetine and Pravastatin Increases Blood Glucose Levels Clinical Pharmacology & Therapeutics 2011 (25 May).)

Cochrane review questions evidence for statins for primary prevention in low risk groups
BMJ 2011; 2011; 342:d480 (24 January)
A Cochrane review published on 18 January questions the evidence for prescribing statins for primary prevention in people at low cardiovascular risk, after finding selective reporting of outcomes, failure to report adverse events, and inclusion of people with cardiovascular disease in published studies.

The reviewers analysed randomised controlled trials of statins in adults with no requirements for participants to have particular LDL or HDL cholesterol concentrations and where no more than 10% of participants had a history of cardiovascular disease (Cochrane Database of Systematic Reviews 2011;(1):CD004816, doi:10.1002/14651858.CD004816.pub4). All studies included also had to have a minimum duration of one year and follow-up of six months. (...)

Statin Use Following Intracerebral Hemorrhage
Arch Neurol. Published 2011 (January 10)
Context Statins are widely prescribed for primary and secondary prevention of ischemic cardiac and cerebrovascular disease. Although serious adverse effects are uncommon, results from a recent clinical trial suggested increased risk of intracerebral hemorrhage (ICH) associated with statin use. For patients with baseline elevated risk of ICH, it is not known whether this potential adverse effect offsets the cardiovascular and cerebrovascular benefits. (...)

Conclusions Avoiding statins should be considered for patients with a history of ICH, particularly those cases with a lobar location. (...)

Meta-analysis: Statin Therapy Does Not Alter the Association Between Low Levels of High-Density Lipoprotein Cholesterol and Increased Cardiovascular Risk
Ann Intern Med2010;153:800-8 (December)
Background: Low levels of high-density lipoprotein cholesterol (HDL-C) are associated with an increased risk for myocardial infarction (MI). Although statins reduce the risk for MI, most cardiovascular events still occur despite statin treatment. (...)

Conclusion: Statins do not alter the relationship between HDL-C level and cardiovascular risk, such that low levels of HDL-C remain significantly and independently associated with increased risk despite statin treatment. The remaining risk seen in statin-treated patients may be partly explained by low HDL-C levels or other factors associated with low levels of HDL-C. (...)

Ingen kreftrisiko ved statiner
dagensmedisin.no 31.8.2010
Den hittil største studien i sitt slag finner ikke holdepunkter for at kolesterolsenkende medisin er forbundet med økt risiko for kreft. Resultatene ble offentliggjort på den europeiske hjertekongressen. (...)

Professor Colin Baigent sier at å redusere LDL-kolesterol med statiner ikke har bivirkninger relatert til kreftutvikling, i det minste ikke over en periode på fem år. (...)

A Burger, Shake, and Some Statins
medpagetoday.com 13.8.2010
Patrons of fast-food restaurants may see packets containing statins next to the ketchup and salt at the self-serve counter if the suggestion of British researchers becomes reality.

Emily Ferenczi, BMBCh, of Imperial College London, and colleagues calculated that most daily statin regimens would be enough to neutralize the increased cardiovascular risk associated with eating a quarter-pounder with cheese and small milkshake every day.

Because statins are cheap, relatively safe even at high doses, and effective for reducing cardiovascular risk across patient subgroups, offering them to individuals who choose to eat an unhealthy diet against best medical advice might make sense, they argued in an editorial in the American Journal of Cardiology.

"It cannot ... be reasonably argued on safety grounds that individuals should be free to choose to eat lipid-rich food but not be free to supplement it with a statin," they wrote. (...)

Statins, Painkillers May Upset PSA Test Results (Statiner, smertestillende legemidler kan forstyrre testresultater for PSA)
health.msn.com 6.8.2010
Common medications might affect prostate cancer diagnoses, researchers say (Vanlige legemidler kan påvirke kreftdiagnoser for prostata, ifølge forskere)

FRIDAY, Aug. 6 (HealthDay News) -- Some of the most widely prescribed drugs in the United States may skew results of prostate cancer screening tests, possibly causing errors in diagnoses, a new study finds.

A prostate cancer diagnosis is typically based on an elevated PSA (prostate-specific antigen)level, but new research shows that common drugs, including cholesterol-lowering statins and certain painkillers, may lower PSA levels. (...)

New Links Between Cholesterol And Depression In The Elderly (Nye linker mellom kolesterol og depresjon hos eldre)
medicalnewstoday.com 22.7.2010
Most people know that high cholesterol levels place them at increased risk for heart disease and stroke. Prior research has shown that particular types of strokes contribute to one's risk for depression, and that abnormal blood lipid levels can increase the risk of depression in the elderly.

However, new findings by French researchers, published in Biological Psychiatry, suggest the link between increased cholesterol and depression may be complicated. They evaluated a large population of elderly men and women (aged 65 and over) over a seven year follow-up period, assessing them for symptoms of depression and measuring their lipid levels. (...)

Sju av ti har for høyt kolesterol
dagbladet.no 26.7.2010
11 000 er arvelig belastet uten å vite det. Sjekk om du er i faresonen.

Sju av ti 40-åringer har for høyt kolesterolnivå i blodet. Blant 60-åringer er andelen åtte av ti. Kolesterol er livsnødvendig, men om nivået i blodet er for høyt, kan det være livstruende.

— Høyt kolesterolnivå i blodet er den viktigste risikofaktoren for hjerteinfarkt. Det er ingen automatisk kobling mellom de to, men andelen som får hjerteinfarkt er langt større blant de med høyt kolesterolnivå, sier Jan I. Pedersen, professor i ernæringsvitenskap ved Universitetet i Oslo. (...)

Good cholesterol may mean little for statin users
reuters.com 21.7.2010
(Reuters) - People with high levels of the so-called good cholesterol HDL tend to have fewer heart attacks but HDL may offer little protective benefit in people who take statins to lower harmful LDL cholesterol, U.S. researchers said on Wednesday.

An analysis of a large study of healthy people who took AstraZeneca's statin drug Crestor to prevent heart attacks found having high HDL was not a good predictor of heart attack risk.

"HDL is a very powerful predictor of future risk" of heart disease, said Paul Ridker of Brigham and Women's Hospital in Boston, whose study appears in the journal Lancet. (...)

Uvitande om kolesterolnivå
nrk.no 19.7.2010
Det tek tre minutt å måla kolesterolet med dette apparatet.

75 prosent av den voksne befolkninga i Norge har høgare kolesterol enn tilrådd. (...)

Høyt kolesterol - hjelper kostendringer og trening?
nhi.no 17.6.2010
Mange får påvist høyt kolesterol og blir oppfordret til å gjøre kostendringer og drive med fysisk trening. Men hvor godt hjelper slike tiltak?

Høyt kolesterol, hyperlipidemi, er en viktig risikofaktor for å utvikle hjertekarsykdom. Ikke-medikamentell behandling anbefales ofte før man starter med fettsenkende (lipidsenkende) legemidler hos de som har for høye lipidverdier. (...)

Det tar tid fra du legger om livsstilen gjennom kostendringer og økt fysisk trening, til det foreligger målbare resultater. Derfor bør slik behandling pågå i minst seks måneder før man tar stilling til om livsstilsendringene virker, eller om man bør starte med lipidsenkende midler, såkalte statiner. Unntaket er pasienter med etablert hjerte/karsykdom der man ofte vil begynne med medikamentell behandling og livsstilomlegging samtidig. (...)

FDA warns Pfizer over reporting side effects (FDA advarer Pfizer over rapportering av sideeffekter)
pharmatimes.com 10.6.2010
Regulators in the USA have issued Pfizer with a warning over what they claim is the company’s failure to report serious and unexpected potential side effects from some of its drugs in a timely fashion.

In a 12-page letter addressed to Pfizer chief executive Jeffrey Kindler, the US Food and Drug Admininstration says delays in reporting side effects date back from 2004 and have increased since then. The treatments cited in the letter include the cholesterol-lowering blockbuster Lipitor (atorvastatin) and the erectile dysfunction drug Viagra (sildenafil).

Ronald Pace, chief of the agency's New York office, writes that the FDA “expects drug manufacturers to establish and implement reasonable mechanisms to assure that all serious and unexpected experiences are promptly recorded and investigated”. For example, while Viagra was known to cause serious visual problems, Pfizer failed to report cases within the agency's 15-day deadline “by misclassifying and/or downgrading reports to non-serious without reasonable justification." (...)

Ingen blodtrykkssenkende tilleggseffekt av statiner
Notiser
Tidsskr Nor Legeforen 2010; 130 (3.6.2010)
Statiners beskyttelse mot hjerte- og karsykdom antas å skyldes endring i lipidprofilen og muligens også antiinflammatoriske og antiproliferative effekter. I tillegg er det forslått at statiner kan senke blodtrykket. Dette har nå vært undersøkt av italienske forskere (BMJ 2010; 340: c1197).

508 pasienter i alderen 45–70 år med mild hypertensjon og hyperkolesterolemi ble randomisert til blodtrykkssenkende behandling med og uten pravastatin i tillegg. Studien viste at pravastatin ikke hadde blodtrykkssenkende effekt når det ble gitt til hypertensive pasienter som fikk effektiv hypertensjonsbehandling. Dette tyder på at de beskyttende kardiovaskulære effektene av statiner ikke er avhengig av en blodtrykkssenkende virkning. (...)

Uvitende om farlig høyt kolesterol
nrk.no 4.3.2010
Over 10.000 nordmenn har arvelig høyt kolesterol uten å vite om det. Det første symptomet kan være et dødelig hjerteinfarkt i ung alder. (...)

Study Raises Questions About Cholesterol Drug’s Benefit
nytimes.com 15.11.2009
ORLANDO, Fla. — For patients taking a statin to control high cholesterol, adding an old standby drug, niacin, was superior in reducing buildup in the carotid artery to adding Zetia, a newer drug that reduces bad cholesterol, according to a new study.

The results of the study, published in The New England Journal of Medicine, were presented here Sunday night at an annual meeting of the American Heart Association.

The study has been a polarizing topic here and has also attracted the attention of a powerful senator who has been investigating the conduct of two drug makers, Merck and Schering-Plough, in relation to their sales and marketing of Zetia and a combination cholesterol drug, Vytorin, which includes Zetia. The drug makers merged this month. (...)

Difficult lipid control is let down by poor evidence
All you need to read in the other general journals
BMJ 2009;339:b4610 (11 November)
(...) Difficult lipid control is let down by poor evidence
Ann Intern Med 2009;151:622-30 [Abstract/Full Text]
When people taking statins fail to achieve their lipid targets, doctors can either increase the dose or add another lipid modifying drug such as a fibrate or ezetimibe. A systematic review looking for the best option found plenty of trials (102), but they weren’t particularly helpful. Only a handful compared the effect of the two strategies on mortality (no difference), and none included other important clinical outcomes such as heart attack, stroke, or need for revascularisation. The mortality data were too weak to be conclusive. (...)

Many trials failed to report side effects or adherence systematically. They were generally small and brief. Few targeted the high risk patients who stand to gain most from strict control of their serum lipids. As usual, there is much more work to be done, say the authors. (...)

Muskelskade etter statinbruk
Tidsskr Nor Legeforen 2009; 129:2208 (5.11.2009)
Bruk av statiner kan medføre muskelskade, men CK-nivå i blod sier lite om skadeomfanget. (...)

AASLD: Antibiotics Top Cause of Drug-Induced Liver Failure (AASLD: Antibiotika topper årsaker til legemiddelindusert leversvikt) (AASLD: The American Association for the Study of Liver Diseases)
medpagetoday.com 5.11.2009
BOSTON -- Antimicrobial agents are the most common cause of drug-induced liver failure, with most cases ending in death or transplant, a researcher said here.

A prospective analysis of some 1,200 cases of acute liver failure found that half of those caused by drugs were associated with antituberculosis, antifungal, sulfa drugs, and other antibiotics, according to Adrian Reuben, MBBS, of the Medical University of South Carolina in Charleston.

Herbal supplements, anticonvulsants, and statins also were relatively common causes of drug-induced liver injury (DILI), Reuben told attendees here at the American Association for the Study of Liver Diseases' annual meeting. (...)

Statins May Worsen Fatigue in Heart Failure Patients
health.msn.com 3.11.2009
But no one's suggesting the drugs should be stopped

TUESDAY, Nov. 3 (HealthDay News) -- Statins may boost the risk of fatigue and shortness of breath in some patients with heart failure, a new study suggests. But a second report found the cholesterol-reducing drugs reduce the risk of clots in those with cardiovascular disease, and experts think the benefits outweigh the risks.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California at Los Angeles, said patients shouldn't reconsider their use of the statins based on the results of the small U.S. study.

"Patients with heart failure who have an indication for statin therapy, such as coronary artery disease or diabetes, should remain on physician-prescribed statin therapy," Fonarow said. (...)

Statin therapy and risk of developing type 2 diabetes: a meta-analysis.
Diabetes Care. 2009 Oct;32(10):1924-9.
OBJECTIVE: Although statin therapy reduces cardiovascular risk, its relationship with the development of diabetes is controversial. The first study (West of Scotland Coronary Prevention Study [WOSCOPS]) that evaluated this association reported a small protective effect but used nonstandardized criteria for diabetes diagnosis. (...)

CONCLUSIONS: Although statin therapy greatly lowers vascular risk, including among those with and at risk for diabetes, the relationship of statin therapy to incident diabetes remains uncertain. Future statin trials should be designed to formally address this issue. (...)

Merck, Schering-Plough in $42M Vytorin settlement
pharmpro.com 6.8.2009
NEW YORK (AP) — Merck and Schering-Plough say they will pay $41.5 million to settle class-action lawsuits filed by patients taking the cholesterol drugs Vytorin and Zetia.

The lawsuits claim that the companies purposefully delayed the release of study results showing the cholesterol treatments were no more effective than older, less expensive medications. The companies do not acknowledge any wrongdoing or liability as part of the settlement.

The settlement deal comes while Whitehouse Station, N.J.-based Merck & Co. is in the process of buying Kenilworth, N.J.-based Schering-Plough Corp. for $41.1 billion. (...)

Merck, Schering-Plough Reach Vytorin Settlement With State AGs
Thompson.com 17.7.2009
Merck & Co., Schering-Plough Corp. and their cholesterol joint venture Merck/Schering-Plough Pharmaceuticals reached a civil settlement with the attorneys general (AGs) of 35 states and the District of Columbia concerning the companies’ promotion of the drugs Vytorin and Zetia and the alleged delay in releasing the results of a related clinical trial.

According to the state enforcement officials, a nearly two-year delay in the release of the full results of the so-called ENHANCE clinical trial violated state consumer protection laws. The trial determined that Vytorin, a cholesterol-lowering drug consisting of a combination of the drugs Zetia and Simvastatin, was no more effective in reducing the formation of plaque in carotid arteries than the cheaper, generically available Simvastatin alone. During the delay in the release of the trial results, the companies heavily promoted Vytorin in direct-to-consumer (DTC) advertisements. (...)

Data About Zetia Risks Was Not Fully Revealed (Data for Ezetrol (Zetia) ble ikke fullstendig offentliggjort)
nytimes.com 21.12.2007
New evidence shows that the drug makers Merck and Schering-Plough have conducted several studies of their popular cholesterol medicine Zetia that raise questions about its risks to the liver, but the companies have never published those results.

Partial results of the studies, alluded to in documents on the Food and Drug Administration’s Web site, raise questions about whether Zetia can cause liver damage when used long term with other cholesterol drugs called statins.

Most of the millions of people who use Zetia take it along with a statin like Lipitor, Crestor or Zocor. Or they take it in a single pill, Vytorin, that combines Zetia with Zocor. (...)

(Anm: Zetia (ezetimibe); markesføres i Norge under handelsnavnet Ezetrol (Zetia i i USA.)

(Anm: Vytorin (ezetimibe and simvastatin); Vytorin er en kombinasjon av Schering-Ploughs Zetia (ezetimibe; fornorsket ezetimib) og Mercks Zocor (simvastatin).)

Ældre har ingen gavn af kolesterolmedicin
hjerteforeningen.dk 31.5.2009
Raske over 70 år får intet ud af at tage medicin mod et for højt kolesterol

Har du passeret de 70 år, er måske ældre, men i øvrigt hjerterask, er der ingen grund til at tage kolesterolsænkende medicin. Også selvom du skulle have et forhøjet indhold af kolesterol i blodet. Nye tal fra Østerbroundersøgelsen slår nu fast, at risikoen ved forhøjet kolesterol daler jo ældre, du er. Og det budskab fortjener, at blive taget alvorligt, mener en af forfatterne bag undersøgelsen Peter Schnohr, hjertelægelæge og dr.med. og i mange år aktiv i Hjerteforeningen:

- Er du rask og fyldt 80 år er det ligegyldigt om dit kolesterol er 4 eller over 8. Er man mellem 70 og 80 skal man blot holde sig under 8. Denne gruppe ældre har bestået den biologiske prøve, hvor det ikke betyder noget, om de har et forhøjet indhold af kolesterol i blodet. Alle der har åreforkalkning, skal dog behandles uanset alder, siger Peter Schnohr. (...)

Resultaterne er netop offentliggjort i det europæiske tidsskrift European Journal of Internal Medicine. (...)

Ingen forskjellar i føreskriving av kolesteroldempande middel mellom dei med høg og låg utdanning
fhi.no 31.3.2009
Menneske med låg utdanning brukar meir kolesteroldempande middel i form av såkalla statin enn dei som er høgt utdanna. Men etter at funna vart justerte for skilnadar i risikofaktorar for hjarte-karsjukdom, var det ingen forskjell i konsum dei to gruppene imellom. Dette viser ein fersk studie frå Folkehelseinstituttet. (...)

Statin use and its association with musculoskeletal symptoms—a cross-sectional study in primary care settings
Family Practice 2009 26(2):88-95
Introduction. Musculoskeletal complaints are very common in primary care settings. Lipid-lowering drugs are one of several causes of musculoskeletal symptoms. However, data showing an association of lipid-lowering drug therapy and increased odds of musculoskeletal complaints in primary care patients are lacking. (...)

Results. The prevalence of lipid-lowering drug prescription was 23% (n = 239) and that of muscular complaints was 40% (n = 411). In all, 44% (n = 106) of the patients with lipid-lowering drug prescription had muscular complaints compared to 39% (n = 305) of the patients without lipid-lowering drug therapy. Statin prescription and 10 variables remained in the final model. Statin prescription is associated with a 1.5-fold odds of musculoskeletal complaints compared to non-prescription {odds ratio [OR] = 1.5 [95% confidence interval (CI), 1.1–2.0], P = 0.02}.

Conclusion. Having a statin prescription appears to be an independent factor associated with musculoskeletal symptoms in primary care settings. Statin use may be more often associated with musculoskeletal complaints than previously assumed. (...)

Cholesterol Drugs Linked to Increased Fatigue
healthday.com 12.3.2009
(...) In the study, researchers led by Beatrice Golomb, associate professor of medicine at the University of California, San Diego, randomly divided 1,016 adults without heart disease or diabetes into three groups and gave them daily doses of 20 milligrams of simvastatin (Zocor), 40 milligrams of pravastatin (Pravachol), or a placebo for six months.

On average, the subjects were in their mid-50s during the study, which took place between 2000 and 2005.
The researchers found that people on simvastatin reported reduced energy and activity levels, while those on pravastatin reported reduced energy levels only. On average, Golomb said that those who took the statins reported levels of energy that were 5 percent lower than those who took a placebo. (...)

Tight control of blood glucose in long standing type 2 diabetes
BMJ 2009;338:b800 (5 March)
Reducing glycated haemoglobin below 7% is not supported by evidence and may even be harmful
During the past year, three important studies have provided evidence that tighter glycaemic control (to <7% glycated haemoglobin) in older adults with type 2 diabetes does not provide substantial benefit and may increase the risk of adverse outcomes. These findings, which some experts and policy makers found surprising, should lead to the re-evaluation of recommendations about what constitutes high quality care for these patients. (...)

Endelig uten bivirkninger
vg.no 1.3.2009
SANDEFJORD (VG) Etter å ha prøvd åtte ulike statiner som alle ga bivirkninger, ble Hypocol redningen for Else-Marie Ivarsen Ottemo (72). (...)

Kolesterolsenkende medisin kan gi øresus
vg.no 21.2.2009
Sammenhengen mellom kolesterolsenkende midler og øresus er lite kjent.

Tinnitus - øresus - har vært assosiert med bruk av statiner og er nevnt som en mindre vanlig bivirkning i preparatomtalen til en av produsentene.

Gjelder alle statiner
Ifølge de Regionale legemiddelinformasjonssentre (RELIS) er det i bivirkningsdatabasen til Verdens Helseorganisasjon (WHO) rapportert tinnitus som bivirkning av alle statinene. (...)

Low Cholesterol, Depression Linked To Early Death
medpagetoday.com 11.2.2009
New Geisinger research shows that men with a combination of low total cholesterol and depression were seven times more likely to die prematurely from unnatural causes, such as suicide and accidents.

The study, which was published recently in Journal of Psychiatric Research, found that men with low total cholesterol (165 milligrams of cholesterol per deciliter or less) and depression were at very high risk for premature death from "external causes" including suicide, drug overdose, accidental poisoning and unintended injuries.

"While it's generally understood that having low cholesterol is a good health sign, combined with other factors, it could actually put a person at risk," said Geisinger senior investigator Joseph Boscarino, PhD, MPH. (...)

Vil gi kolesterol-medisin til friske personer
SIGRID ANNA EGGEN
aftenposten.no 10.2.2009
Tusenvis av liv kan reddes ved å gi friske personer statiner, hevder britisk hjerteekspert.

At statiner er et effektivt legemiddel mot hjerte- og karsykdommer, har lenge vært kjent. I en ny studie uført av israelske forskere, kommer det imidlertid fram at det kolesterolnedsettende middelet er langt mer effektivt en tidligere antatt, melder BBC

Ifølge studien kan statiner nesten halvere risikoen for hjerteinfarkt. (...)

Taking Statins Faithfully Lengthens Life
healthfinder.gov 9.2.2009
But experts note finding colored by fact that these folks take better care of themselves generally.

(SOURCES: Mark A. Hlatky, M.D., professor, health research policy and medicine, Stanford University, Stanford, Calif.; Erica Spatz, M.D., fellow, Robert Wood Johnson Clinical Scholars Program, Yale University, New Haven, Conn.; Feb. 9, 2009, Archives of Internal Medicine)
MONDAY, Feb. 9 (HealthDay News) -- A massive Israeli study finds that people with high cholesterol levels who faithfully take statins are less likely to die over four to five years than those who neglect the therapy.

But that finding is not necessarily a tribute to the effectiveness of the cholesterol-lowering therapy, American experts said. Previous studies have shown that people who follow doctors orders about taking drugs are more likely to follow other rules of good health, they said. (...)

Statins Don't Cut Cancer Risk
healthfinder.gov 5.2.2009
Animal study found 2 popular cholesterol-lowering drugs had little effect on tumors.

THURSDAY, Feb. 5 (HealthDay News) -- Statins have clearly proven their mettle against heart disease, but the cholesterol-lowering drugs don't appear to possess cancer-fighting powers, a new animal study shows.

"We certainly didn't see any positive effects," said Ronald Lubet, program director in the division of cancer prevention at the National Cancer Institute. He led the study using mice and rats, which was published in the February issue of Cancer Prevention Research. (...)

FDA Says ENHANCE Results Do Not Shake Cholesterol Theory
medpagetoday.com 8.1.2009
ROCKVILLE, Md., Jan. 8 -- When it comes to cholesterol, lower is still better and lowest may be the best, according to the FDA, which said today that it has completed its review of data from the ENHANCE trial.

In that study, the simvastatin/ezetimibe combination Vytorin lowered LDL by 56% but did not translate into a measurable reduction in atherosclerotic plaque.

When the results of ENHANCE -- which compared simvastatin alone to the combination drug in patients with heterozygous familial hypercholesterolemia -- were announced at a press conference a year ago, they touched off a series of controversies, not the least of which was a debate over the real benefit of cholesterol-lowering interventions. (See coverage of the ENHANCE controversy.) (...)

FOXSexpert: 4 Common Drugs That Sabotage Your Sex Life
foxnews.com 11.12.2008
(...) 1. Cholesterol-Lowering Medications
To love someone with all your heart can't be taken literally when you're on this type of medication. Cholesterol-lowering meds have impotence and decreased sexual desire as primary sexual side-effects. They can make it harder to make love.

As published in Family Practice, a 2002 systematic review of the literature on erectile dysfunction (ED) and lipid-lowering drugs found that the evidence supports the link between both statins, like Lipitor and Zocor, and fibrates, like TRICOR, and ED.

While some people cannot forego cholesterol-lowering medications, all individuals taking them should seek natural ways to lower cholesterol. These include switching to a low-fat, high-fiber diet and increasing the amount of weekly exercise.

Case in point: To avoid increasing his dosage, my father started walking eight miles a day. Two weeks later, he had lost 10 pounds. Two months later, he was told that he’d brought down his cholesterol. I have yet to ask him how it affected his love life ... (...)

Eat Your Statins
forbes.com 16.11.2008
New research makes a pretty conclusive case for putting millions more Americans on cholesterol drugs.

Want to avoid a heart attack? Stop taking your vitamins and switch to a cholesterol-lowering statin drug instead. (...)

The drugs have side effects, including muscle weakening, that can be dangerous in some cases. Nobody is advocating putting really healthy patients on statins. (...)

The immediate hype surrounding the Jupiter study is about adding the new blood test, for C-reactive protein (CRP). It measures inflammation in the arteries that can cause heart attacks. But far more important will be the way this massive trove of data--18,000 patients' information--solidifies the already rosy view cardiologists have of statin drugs; it will also be invaluable for silencing critics. Jupiter lead author Paul Ridker discloses he has patents on the test. Some researchers quoted here, including Ridker, have financial links to drugmakers. (...)

One statin critic not backing down is John Abramson, author of Overdosed America. He points out that patients on Crestor had the same rate of serious illnesses requiring hospitalization as those on placebo. "You haven't improved their net health," says Abramson. Instead, he argues, you're trading heart attacks and strokes for other serious illnesses. And he contends that not offering weight-loss counseling to an overweight population created an "artificial situation" that exaggerated the benefits of the drug. He's not alone. Stephen Colbert of Comedy Central's fake news show The Colbert Report joked the study was "a great breakthrough in the battle to find things to prescribe to people who don’t need them." (...)

Statins and primary prevention of cardiovascular events
BMJ 2008;337:a2576 (14 November)
No change in strategy is needed despite the hype surrounding the recent JUPITER study (...)

The relative risk reduction (44%) was also much higher than in previous trials. Although the authors suggest that measuring C reactive protein allows the selection of a group of patients who benefit more than others, alternative explanations should be considered. Because participants in both the intervention and control groups had low concentrations of LDL-C, controls were presumably not taking non-study statins. This is in contrast to many previous trials, where up to 17% of patients in the control group were taking non-study statins, which diluted the positive effect. 2 3 Moreover, a four week placebo run-in phase allowed the JUPITER investigators to select highly compliant patients. This also limits the external validity of the trial. (...)

Missing The Point On Crestor
forbes.com 13.11.2008
I think a lot of the debate on the Jupiter study of AstraZeneca's Crestor is way off-base in all sorts of ways, on all sides. But here's a key distinction health wonks and investors should both make. The study will increase statin use and Crestor sales, but not for the same reasons.

Jupiter will increase the use of statins (many of them generic) because it provides the strongest evidence yet that a statin will reduce just about anybody's relative risk of getting a heart attack or stroke. So the only question is whether your absolute risk is high enough to justify getting it down. (...)

A New Age Of Statins?
forbes.com 9.11.2008
A new study could lead millions more Americans to take cholesterol-lowering drugs and generate billions in sales for AstraZeneca, which funded it. But first comes a furious debate. (...)

Because the patients in the study had a relatively low risk of heart attack, the absolute benefit of taking Crestor was still very small. There were only 400 heart attacks, strokes or heart surgeries among all 18,000 patients in the study. Overall, 95 patients had to be treated with Crestor for two years to prevent one angioplasty procedure, heart attack or other cardiovascular "event." (...)

Justice Department Investigates Vytorin Marketing, More Lawsuits Face Merck, Schering
kaisernetwork.org 5.11.2008
Merck and partner Schering-Plough face an investigation by the U.S. Department of Justice and an increasing number of lawsuits over their marketing of cholesterol drug Vytorin, according to a filing to the Securities and Exchange Commission on Monday, the AP/Miami Herald reports. Merck and Schering, after being pressured by congressional investigators, in January released results of a "long-delayed" study that found Vytorin was no more effective than the generic cholesterol drug Zocor, which costs one-third as much. The findings resulted in investigations by the Senate Finance Committee and the House Committee on Energy and Commerce Subcommittee on Oversight and Investigations regarding whether the companies deliberately delayed the results to maintain sales of Vytorin and Zetia. (...)

Statin side effects: Weigh the benefits and risks
mayoclinic.com 30.10.2008
Statin side effects can be very uncomfortable, making it seem like the risks outweigh the benefits of these powerful cholesterol-lowering medications. Consider the risks and benefits.

Because of their effectiveness, statins are often prescribed for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Most people who are prescribed statins will take them for the rest of their lives, which can make statin side effects difficult to manage.

For some people, statin side effects can make it seem like the benefit of taking a statin isn't worth it. Before you decide to stop taking a statin, discover how statin side effects can be reduced. (...)

Medisinsk forskning og doping
Tidsskr Nor Legeforen 2008; 128:2224 (9.10.2008)
I 2004 laget ni eksperter nye retningslinjer for hva som skulle være behandlingstrengende høyt kolesterolnivå i USA. Retningslinjene ville medføre at nye millioner amerikanere ville bli satt på statiner. Problemet var at åtte av de ni kolesterolekspertene var på statinfabrikantenes lønningslister (1). Spørsmålet er om disse ekspertene er i stand til å lage retningslinjer uavhengig av den industrien de er knyttet til. (...)

Blir man glemsk av statiner?
Tidsskr Nor Legeforen 2008; 128:2224
I sommer fant det sted en debatt i Aftenpostens spalter om bivirkning av statiner (1 - 3) som jeg synes det kunne være verdt å bringe videre. Blir man glemsk av statiner? For den som vil lese en utfyllende oppsummering av dagens viten på dette området, henviser jeg i første rekke til en oversiktsartikkel fra 2006 (4). Selv har jeg også skrevet om emnet (5). (...)

Statins Linked to Increased Risk of Postoperative Delirium
medpagetoday.com 22.9.2008
TORONTO, Sept. 22 -- Older patients who take statins regularly, particularly those past 70, have an increased risk of delirium following elective surgery, researchers here reported.

After adjusting for other variables -- including age and length of surgery -- statin use was associated with a 28% increased risk of postoperative delirium (P<0.001), according to Donald A. Redelmeier, M.D., of Sunnybrook Health Services Center of the University of Toronto, and colleagues.

The association emerged from a population-based retrospective cohort analysis of 284,158 consecutive elective surgery patients older than age 65, Dr. Redelmeier and colleagues reported in the Sept. 23 issue of the Canadian Medical Association Journal. (...)

Ikke lavere dødelighet med statiner (12.09.08)
legemiddelsiden.no 12.9.2008
Statiner har ingen effekt på overlevelsen hos pasienter med hjertesvikt, ifølge en ny studie. - Dette viser at statiner ikke har noen rutineplass ved oppstart av behandling for hjertesvikt, mener professor og seksjonsoverlege Lars Gullestad. (...)

Omega-3 bättre än läkemedel vid hjärtsvikt
dn.se 31.8.2008
Kapslar med omega-3-fettsyror ger personer med hjärtsvikt ett visst skydd mot hjärtsjukdom och plötslig död. Men det gör inte det kolesterolsänkande läkemedlet Crestor. Det visar två italienska studier från den pågående hjärtkongressen i München.

DET ÄR INGEN IDÉ för personer som har relativt allvarlig hjärtsvikt att ta det kolesterolsänkande läkemedlet Crestor. Den slutsatsen går att dra av en italiensk studie som har testat behandlingen på över 4.500 personer med allvarlig hjärtsvikt.

Hälften fick Crestor, 10 milligram per dag, och hälften placebo, verkningslös behandling. Efter nästan fyra års behandling kunde forskarna konstatera att det inte var någon skillnad i sjuklighet och dödlighet mellan de som fått läkemedlet och de som inte fått det.

Fyndet bekräftar en tidigare publicerad studie berättar Lars Wallentin, professor i kardiologi (läran om hjärtat) vid Uppsala kliniska forskningscentrum och Akademiska sjukhuset i Uppsala. (...)

FDA to Explore Possible Vytorin-Cancer Link
webmd.com 21.8.2008
(...) In the trial, called SEAS, 4.1% of patients taking Vytorin died of cancer -- more than the 2.5% of patients who received an inactive placebo. A July statement issued by the study investigators noted that these differences "are small and could have occurred as a result of chance."

Vytorin is jointly marketed by Merck and Schering-Plough. Merck has provided the study data to independent researchers for analysis. Now the FDA says it is conducting its own safety review. (...)

(Anm: Ezetimibe/Simvastatin (marketed as Vytorin) Simvastatin (marketed as Zocor) Ezetimibe (marketed as Zetia).)

SLCO1B1 Variants and Statin-Induced Myopathy — A Genomewide Study
NEJM 2008;359:789-799 (August 21)
Background Lowering low-density lipoprotein cholesterol with statin therapy results in substantial reductions in cardiovascular events, and larger reductions in cholesterol may produce larger benefits. In rare cases, myopathy occurs in association with statin therapy, especially when the statins are administered at higher doses and with certain other medications. (...)

Cholesterol drugs linked to muscle pain (Kolesterollegemidler linket til muskelsmerte)
seattletimes.nwsource.com 10.8.2008
Q: I was on Lipitor for a number of years and have severe muscle and nerve damage to the extent that I am in a power wheelchair. Do you think Lipitor could be to blame?

A: Statin-type cholesterol-lowering drugs such as Crestor (rosuvastatin), Lipitor (atorvastatin), Mevacor (lovastatin) and Zocor (simvastatin) are linked to muscle pain, weakness and nerve damage. Most physicians have assumed that muscle problems are an extremely rare side effect.

New research (New England Journal of Medicine online, July 23, 2008) suggests that some people are highly susceptible to muscle-related complications from high-dose statins. This genetic vulnerability may affect up to one-fourth of the population. (...)

FDA Issues Alert on Rhabdomyolysis Risk When Combining Simvastatin with Amiodarone (Advarsel fra FDA om risiko for rabdomyolyse når Simvastatin kombineres med Amiodarone)
medpagetoday.com 8.8.2008
ROCKVILLE, Md., Aug. 8 -- The FDA has again warned of a dose-dependent increased risk of rhabdomyolysis when simvastatin (Zocor) at more than 20 mg is used in combination with amiodarone (Cordarone, Pacerone).

The simvastatin label was modified in 2002 to add a warning about the increased risk, but the FDA said today that it continues "to receive reports of rhabdomyolysis in patients treated concurrently with amiodarone and simvastatin, particularly with simvastatin doses greater than 20 mg daily."

The FDA said the precise mechanism was unknown, but was related to the fact that amiodarone inhibits the cytochrome P450 3A4 (CYP3A4) enzyme. This is the same enzyme that metabolizes simvastatin. (...)

(Anm: rabdomyolyse; nedbryting eller oppløysing av tverrstripete muskulatur som gir auka innhald i serum av myoglobin og ymse muskelvevsenzym; kan stundom koma som skadeverknad ved bruk av glutetimid, amfetamin, salisylat, fencyclidin, teofyllamin eller andre medikament eller pga virussjukdommar, slangebit, sterk muskelrøyning m v; kan vera årsak til farleg hyperkalemi, kan gi nyresvikt pga myoglobinopphoping i nyrene; kan stundom skuldast mangel på carnitinpalmityltransferase, eit enzym i feittstoffskiftet; jf Meyer-Betz' sjukdom
EN rhabdomyolysis Kilde: Norsk medisinsk ordbok.)

Cholesterol Drugs May Protect Memory (Kolesterollegemidler kan beskytte hukommelse)
ivanhoe.com 30.7.2008
(Ivanhoe Newswire) -- Drugs commonly used to fight cholesterol may also ward off dementia and memory loss. (...)

The statins the participants took included atorvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, rosuvavstatin and simvastatin. Headaches, nausea, fever and muscle pain are the most common side effects of the drugs. (...)

(Anm: Use of statins and incidence of dementia and cognitive impairment without dementia in a cohort study. NEUROLOGY 2008;71:344-350.)

Statins May Spur Dementia (Statiner kan tilskynde demens)
newsmax.com 25.7.2008
(...) Statin drugs, which are used to lower cholesterol, may adversely affect a particular group of brain cells important to the health of aging brains, according to researchers at the University of Rochester Medical Center. “There has been a great deal of discussion about a link between statins and dementia, but evidence either way has been scant,” said Steven Goldman, M.D., Ph.D., the research team leader. “This new data provides a basis for further exploration.”

The team looked specifically at the effect of statins on “glial progenitor cells.” These are flexible brain cells held in reserve which the brain can change and customize according to whatever type of cell it needs to stay healthy. The researchers found that statin drugs spur the glial progenitor cells, which are similar to stem cells, to become a particular kind of cell and to lose their crucial ability to change. In other words, statins cause the cells to take a final form of some kind which the brain can no longer modify or transform. (...)

Kolesterol-medicin kan ødelægge dit sexliv
bt.dk 23.7.2008
Ny forskning afslører alvorlige bivirkninger - bl.a. depression og seksuelle problemer - i 500.000 danskeres medicin

Den mest anvendte medicin i Danmark - kolesterolsænkende midler - viser sig nu at have meget alvorlige bivirkninger. 'Mirakelmidlet', som det er blevet udråbt til fra alle sider, kan bl.a. smadre din hukommelse og dit sexliv.

De såkaldte statiner, som mere end en halv million voksne danskere hver dag tager for at sænke kolesterol -tallet og for at undgå blodpropper, kan i nogle tilfælde være årsag til en alvorlig og måske ligefrem livstruende lungesygdom, og mange af brugerne har vist sig at få alvorlige depressioner, søvnforstyrrelser, hukommelsessvigt og seksuelle problemer.

I forvejen er det kendt, at kolesterol -medicinen kan give både muskelsmerter og muskelsvaghed.

- Der er tale om så alvorlige bivirkninger, at vi nu i EU-regi vil stille krav om, at der laves nye indlægssedler i pilleæskerne med advarsler. (...)

Læger advarer mod kolesterolmedicin
netdoktor.com/dk 22.7.2008
En bestemt type kolesterolnedsænkende medicin, statiner, kan have alvorlige bivirkninger som for eksempel depression, søvnforstyrrelser, hukommelsessvigt og seksuelle problemer. Det viser nye test og en række indberetninger fra læger.

”Der er tale om så alvorlige bivirkninger, at vi nu i EU-regi vil stille krav om, at der laves nye indlægssedler i pilleæskerne med advarsler”, oplyser Dorte Stenver afdelingschef i Lægemiddelstyrelsen,

Dorte Stenver er i øjeblikket i London, hvor hun deltager i et udvalg under EUs lægemiddelkomité, der skal se nærmere på det lægemiddel, som en halv million danskere hver dag tager.

Dorte Stenver vil dog ikke råde folk til stoppe med pillerne, men i stedet diskutere eventuelle bivirkninger og finde en individuel løsning i samråd med egen læge.

Læge og docent Uffe Ravnskov, der forsker i kolesterol, er dog meget skeptisk over for bivirkningerne.

”Der er tale om så alvorlige bivirkninger, at jeg personligt ville tænke mig rigtig godt om, før jeg fortsatte med at tage pillerne. Bivirkningerne – risikoen ved medicinen – overskygger helt klart de positive virkninger, siger Uffe Ravskov. (...)

(Anm: - Den observerte sammenhengen mellom bruk av sovepiller og forhøyet LDL kolesterol er spesielt bekymringsfullt gitt den dramatiske økningen i bruken av beroligende legemidler i den generelle befolkningen i de senere år. ("The observed link between sleeping pill use and elevated LDL cholesterol is particularly concerning given the dramatic rise in the use of sedative medicine in the general population in recent years," he said.) (medicalnewstoday.com 1.3.2016).)

Knasket piller for åtte milliarder
dinside.no 21.7.2008
Sjekk hvilke vi spiser mest av. (...)

- Legemiddelforbruket i 1. halvår er 15 prosent høyere enn for fire år siden, mens kostnadene er ca ti prosent høyere. (...)

Statiner, et legemiddel mot forhøyet kolesterol, er blant de legemidlene som øker mest. Bruken av det vanligste statinet, simvastatin, har økt med hele 27 prosent fra i fjor til i år. (...)

Simvastatin vs therapeutic lifestyle changes and supplements: randomized primary prevention trial
Mayo Clin Proc. 2008 Jul;83(7):758-64.
CONCLUSION: Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin. Pending confirmation in larger trials, this multifactorial, alternative approach to lipid lowering has promise for a subset of patients unwilling or unable to take statins. (...)

Norsk studie ryster Wall Street
dn.no 21.7.2008
Aksjene i de to legemiddelgigantene Schering-Plough og Merck falt brutalt etter offentliggjøringen av en norskledet studie.

Allerede i mars ble det sådd tvil om kolesterolpillen Vytorin hadde noen effekt. Nå blir en ny studie, som knytter legemiddelet til økt fare for kreft, offentliggjort langt tidligere enn det som var planlagt, skriver Bloomberg News.
Vytorin, som er et legemiddel som er en kombinasjon av Mercks Zocor og Schering-Ploughs Zetia, var antatt å ha en reduserende effekt på komplikasjoner knyttet til hjerteklaffsykdommer.

Uten effekt
Studien som ble ledet av Terje Pedersen ved Ullevål Universitetssykehus, viser at legemiddelet synes å redusere én type hjertesykdom (coronary artery-tilstander), men ikke utviklingen av hjerteklaff-sykdommer (aortic valve disease). Det første stemmer med tidligere funn, men den ferkseste studien var utviklet nettopp for å stadfeste om legemiddelet hjalp på en hjertesyk som kalles aortic stenosis, som innebærer at aortaklaffen smalner.

Salget av Vytorin har falt med en tredel siden det i mars ble stadfestet at Vytorin ikke var mer effektiv enn det ene legemiddelet alene. (...)

Ezetimibe/Simvastatin (Vytorin) Misses Major Cardiovascular Endpoints in SEAS Trial
medpagetoday.com 21.7.2008
LONDON, July 21 -- Treatment with ezetimibe/simvastatin (Vytorin) has revealed no slowing of progression of aortic stenosis in asymptomatic patients but found an association with a lower risk of ischemic events, researchers here reported.

At the same time, in the 1,800-patient SEAS study (Simvastatin and Ezetimibe in Aortic Stenosis), investigators found a marked increase in the number of malignancies, reported Terje Pedersen, M.D., of Ulleval University Hospital in Oslo, Norway. (...)

Dr. Peto analyzed data culled from the two ongoing trials and concluded that those data do not support an increased risk of cancer. Moreover, he said it was highly unlikely that a risk factor could explain a 50% increase in cancer in only three years. But that type of increase could be explained by the play of chance. At a press conference, Dr. Peto said he had forwarded his findings to the FDA and other regulatory agencies worldwide. (...)

Statin drug no aid for a learning disability: study
reuters.com 15.7.2008
CHICAGO (Reuters) - One form of statins, the cholesterol fighter that is the world's top selling drug, does not appear to help children overcome a common, genetically linked learning disability, researchers said on Tuesday. (...)

AAN: Statins Hold No Beneficial Effects for Alzheimer's Disease
medpagetoday.com 17.4.2008
Atorvastatin (Lipitor) was associated with no significant improvement in cognitive scores (P=0.26) or global function scores (P=0.73), reported Howard Feldman, M.D., of the University of British Columbia in Vancouver, and colleagues here at the American Academy of Neurology meeting.

These findings from the LEADe study provided much-needed randomized, placebo-controlled evidence, Dr. Feldman said. (...)

Sen. Grassley Requests Information on Delay of Results of Study on Cholesterol Medication Vytorin
kaisernetwork.org 1.4.2008
Senate Finance Committee ranking member Chuck Grassley (R-Iowa) on Monday sent a letter to the CEOs of Merck and Schering-Plough that requested additional information about their decision to wait for more than one year to release the results of a study on the cholesterol medication Vytorin, marketed by a joint venture between the companies, the Wall Street Journal reports (Winslow, Wall Street Journal, 4/1). (...)

TRIAL AND ERROR
Delays in Drug's Test (Forsinkelser i legemiddeforsøk)
wsj.com 24.3.2008
Fuel Wider Data Debate

In January, Merck & Co. and Schering-Plough Corp. disclosed surprising news: A long-overdue study of their blockbuster cholesterol drug Vytorin found it was no better at fighting heart disease than a far-cheaper generic. Doctors and public officials questioned whether the companies had delayed the results for more than a year to protect billion of dollars in sales. (...)

The Vytorin study has fueled two broad controversies, both likely to be stoked this week as the findings are formally presented for the first time. Its handling has sharpened the debate over how much control sponsors should wield in clinical trials that influence doctors and regulators. And the study's results have led some skeptical doctors to question the value of cholesterol-lowering drugs that have become the front-line medical weapon against heart disease, the Western world's leading killer. (...)

Dutch researcher John Kastelein, the outside scientist who led the study, has called it "a trial from hell." (...)

Probing Mitochondria for Statin Myopathy Mystery
medpagetoday.com 25.2.2008
BOSTON, Feb. 25 -- Studies of the mitochondria have offered hints into the etiology of the myopathy that strikes a small percentage of those who take lipid-lowering statins -- heretofore a puzzle for clinicians.

A new way to look at mitochondria devised by Vamsi Mootha, M.D., of Harvard Medical School, and colleagues suggests a cause for the unusual condition and may explain why some studies were unable to find an association.

Dr. Mootha and colleagues reported online in Nature Biotechnology a chemical-genomic method that allows researchers to probe the activity of mitochondria organelles while they are in living muscle cells. (...)

The technique allows them to "read out" several elements of mitochondrial function, including levels of adenosine triphosphate (ATP), production of reactive oxygen species, and electron flux in and out of the organelle, he said.

The method also allows them to monitor expression of about 40 mitochondrial and nuclear genes involved in energy homeostasis, Dr. Mootha said.

"It's a really rich read-out of what's happening to mitochondria in different conditions," Dr. Mootha said. (...)

Unreported cholesterol drug data released by company
BMJ 2008;336:180-181 (26 January)
The makers of a popular cholesterol lowering drug have posted results of a study showing it was ineffective—but only after a Congressional inquiry was set up to look into why they had not published their results two years after the study was completed.

Merck and Schering-Plough Pharmaceuticals, manufacturers of ezetimibe (Zetia), posted results on their websites earlier this month showing that 356 people treated with ezetimibe (10 mg) plus simvastatin (80 mg) fared no better than 360 who had received simvastatin alone (www.sch-plough.com/schering_plough/news/release.jsp?releaseID=1095943). (...)

Patients sue over cholesterol drug marketing
msnbc.msn.com 24.1.2008
Lawsuits claim drugmakers misled consumers about effectiveness

TRENTON, N.J. - The makers of popular cholesterol drugs Vytorin and Zetia are being sued in at least four states over allegations that Merck & Co. and Schering-Plough Corp. misled consumers into thinking the drugs were more effective than generic ones. (...)

Vytorin Ad Shame Taints Entire Marketing Industry
adage.com 21.1.2008
Cholesterol Drug's Ad Campaign Turns Into PR Nightmare, Fanning Flames of Public Mistrust of DTC (...)

Study sees no Alzheimer's protection from statins
reuters.com 16.1.2008
WASHINGTON (Reuters) - Cholesterol-lowering drugs called statins do not protect against Alzheimer's disease as some previous research has suggested, a study published on Wednesday said. (...)

At the beginning, 119 of the participants were taking a statin drug. Over the course of the study, 191 people developed Alzheimer's disease, the researchers reported in the journal Neurology.

"We did not find that statins were associated with a lower risk of Alzheimer's disease, with less decline in thinking ability, or with Alzheimer's disease changes in the brain at time of death," Arvanitakis, part of the Rush Alzheimer's Disease Center, said in a telephone interview.

Taking statins also did not protect against memory loss, Arvanitakis added. (...)

Cholesterol as a Danger Has Skeptics
nytimes.com 17.1.2008
For decades, the theory that lowering cholesterol is always beneficial has been a core principle of cardiology. It has been accepted by doctors and used by drug makers to win quick approval for new medicines to reduce cholesterol.

But now some prominent cardiologists say the results of two recent clinical trials have raised serious questions about that theory — and the value of two widely used cholesterol-lowering medicines, Zetia and its sister drug, Vytorin. Other new cholesterol-fighting drugs, including one that Merck hopes to begin selling this year, may also require closer scrutiny, they say. (...)

Drug trials under pressure
usatoday.com 16.1.2008
On the eve of a date with congressional investigators, executives from Merck and Schering-Plough acknowledged Monday that their blockbuster cholesterol drug, Vytorin, offered no benefit over Zocor.

The news that Vytorin fell short of an old stand-by statin drug, now sold as a cheap generic, sent worried patients scurrying to call their doctors for reassurance and advice. (...)

Don't panic over heart drug news, U.S. group advises
reuters.com 15.1.2008
WASHINGTON (Reuters) - News that the popular cholesterol drug Vytorin may not work to protect arteries and may in fact worsen clogging should not cause patients to panic, the American College of Cardiology said on Tuesday. (...)

Study Reveals Doubt on Drug for Cholesterol
nytimes.com 15.1.2008
A clinical trial of a widely used cholesterol drug has raised questions both about the medicine’s effectiveness and about the behavior of the pharmaceutical companies that conducted the study, cardiologists said Monday.

Merck and Schering-Plough, which make the drug, Zetia, and a pill that contains it, Vytorin, said Monday morning that Zetia had failed to benefit patients in a two-year trial that ended in April 2006.

Merck and Schering repeatedly missed their own deadlines for reporting the results, leading cardiologists around the world to wonder what the study would show. At the same time, millions of patients have continued taking Zetia and Vytorin.

The drug companies blamed the complexity of the data for the delay. Now, barely a month after news articles noted the delay and Congress pressured the companies to disclose the study’s findings, the results are out.
(...)

Dr. Steven E. Nissen, the chairman of cardiology at the Cleveland Clinic, said the results were “shocking.”

“This is as bad a result for the drug as anybody could have feared,” said Dr. Nissen, a widely published researcher and senior consulting editor to the Journal of the American College of Cardiology. (...)

Solo drug as good as cholesterol combo
usatoday.com 14.1.2008
NEWARK — A controversial trial of the popular and costly cholesterol-lowering drug Vytorin showed that it offered no benefit over an older drug available in generic form, Merck and Schering-Plough said Monday. (...)

What's Next For Vytorin?
forbes.com 15.1.2008
When Merck and Schering-Plough revealed Monday that the active ingredient in their top-selling cholesterol meds Zetia and Vytorin had flunked a clinical trial measuring its effect on artery plaque, they opened themselves up to a barrage of attacks. (...)

Statins Can Boost Brain Hemorrhage Risk After Stroke
healthfinder.gov 13.12.2007
For most patients, small risk is outweighed by the benefits, experts say. (...)

The report is published in the Dec. 12 online edition of Neurology.

In the study, Goldstein's group analyzed data from the Stroke Prevention with Aggressive Reduction in Cholesterol Levels (SPARCL) trial. In SPARCL, 4,731 people received 80 milligrams of Lipitor daily or placebo. (...)

Trial of Cholesterol Drug Gets House Scrutiny
nytimes.com 12.12.2007
A Congressional committee is investigating Merck and Schering-Plough for their handling of a critical clinical trial of Zetia, their blockbuster cholesterol-lowering drug.

On Tuesday, the House Committee on Energy and Commerce demanded more information about delays in the trial, which was completed in April 2006 but whose results have not yet been released.

In a letter to Merck and Schering, the committee’s top two members asked officials at both companies to agree to talk to investigators and said both companies should retain important documents about the trial, called Enhance. (...)

Cholesterol seen tied to heart disease, not stroke (Kolesterol knyttet til hjerteykdom, ikke slag)
reuters.com 29.11.2007
WASHINGTON (Reuters) - Researchers aiming to establish whether high cholesterol raises the risk of stroke said on Thursday they were baffled by findings indicating lower cholesterol levels were not linked to reduced stroke deaths.

They said their analysis of 61 previous studies involving almost 900,000 adults, conducted mostly in western Europe and North America, clearly showed that people with lower total blood cholesterol levels had a lower heart disease death rate.

But the researchers found no relationship between total cholesterol levels and risk of stroke death, especially at older ages and among people with higher blood pressures. (...)

Cardiologists Question Delay of Data on 2 Drugs
nytimes.com 21.11.2007
Prescriptions for the cholesterol-lowering drugs Zetia and Vytorin are written for almost 800,000 Americans every week, at a cost this year of about $4 billion. Yet it still is not clear how well the drugs work.

Nearly two years after the medicines’ makers, Merck and Schering-Plough, completed a clinical trial of the drugs, they still have not released the findings.

The delay has led to a growing chorus of complaints from cardiologists. And yesterday, the companies responded by promising to publish a portion of the results next March — but not the entire set of data. (...)

Cholesterol Drug Tied to Sleep Disturbances (Legemiddel mot kolesterol knyttet til søvnforstyrrelser)
drugs.com 7.11.2007
A new report found that the statin Zocor disrupts sleep patterns in some users.

"The study suggests that simvastatin [Zocor] is more likely to have sleep disruption," said Dr. Sidney Smith, past president of the American Heart Association and director of the Center for Cardiovascular Science and Medicine at the University of North Carolina School of Medicine. "The extent to which this would be a significant problem for patients is uncertain, but this should raise awareness that symptoms could be related to therapy." (...)

Crestor minskar inte risken att dö
lakemedelsvarlden.se 6.11.2007
Aztrazenecas statinpreparat Crestor påverkar inte dödligheten hos patienter med hjärtsvikt. Det visar den stora internationella Corona-studien. (...)

Snabb ökning av förebyggande hjärtläkemedel till unga
lakemedelsvarlden.se 1.11.2007
En amerikansk studie visar att användning av kolesterolsänkande och blodtryckssänkande läkemedel ökar snabbt bland yngre personer. Experter varnar för ökad livslång förebyggande läkemedelsbehandling hos allt fler allt tidigare. (...)

The Secrets Of Pfizer's Toxic Pill
forbes.com 5.11.2007
(...) Researchers speculating about what went wrong thought perhaps torcetrapib made HDL that didn't work, or that HDL itself (short for high-density lipoprotein, and often called "good cholesterol") was less powerful than they thought. Now the results from that trial are finally in, published in the New England Journal of Medicine and presented here at the annual scientific meeting of the American Heart Association. (...)

Mom's Low Cholesterol Tied to Preemie Births
healthfinder.gov 1.10.2007
Nutritional deficiencies and genetics may be to blame, researchers suggest.

(SOURCES: Max Muenke, M.D., chief, medical genetic branch, U.S. National Human Genome Research Institute, National Institutes of Health, Bethesda, Md.; Robert Welch, M.D., chairman and program director, obstetrics and gynecology, St. John Health's Providence Hospital, Southfield, Mich.; October 2007, Pediatrics)

MONDAY, Oct. 1 (HealthDay News) -- While lower cholesterol is generally considered a good thing, new research suggests that very low cholesterol levels in pregnant women may harm the health of the fetus.

Expectant mothers whose total cholesterol levels were under 159 milligrams per deciliter (mg/dL) gave birth -- on average -- to babies weighing about one-third of a pound less than babies born to mothers whose cholesterol levels exceeded 159 mg/dL, the researchers found. (...)

(Anm: Editorials. Statins in pregnancy BMJ 2015;350:h1484.) (Published 17 March 2015).)

Pfizer study shows risk of cholesterol pill switch
today.reuters.com 5.9.2007
VIENNA (Reuters) - Patients switching from Pfizer's branded cholesterol pill Lipitor to Merck & Co's Zocor -- now available as a cheap generic -- are more likely to have a heart attack or die, according to a Pfizer-backed study. (...)

Pfizer's study covered records from 1997 to 2005 and compared outcomes for 2,511 patients who took Lipitor for six months and then switched to simvastatin -- the generic name for Zocor -- with 9,009 who stayed on Lipitor.

The conclusion was that switching was associated with a 30 percent increase in the relative risk of major cardiovascular events, including heart attacks, strokes and death.

The reasons for switching were not given and patients were not randomly assigned to each arm of the study, limiting its significance. Nonetheless, Pfizer said it raised concerns. (...)

Statins may help lower risk of getting Alzheimer's, says study - 29/08/2007
pharmatimes.com 29.8.2007
Mass medicating with statins would 'slash' CV disease (...)

Cutting Cholesterol, an Uphill Battle
PERSONAL HEALTH
nytimes.com 21.8.2007
Last December, a routine nonfasting blood test revealed that my total cholesterol level, which had long wavered between 190 and 205 milligrams per deciliter of blood serum, was now 222 and flagged as “high” by the laboratory’s computer. A heart-healthy reading should be under 200. (...)

- Høyt kolesterol forlenger livet
dagbladet.no 20.8.2007
(Dagbladet.no:) Overlege Tor Ole Kjellevand ved Hjertemedisinsk avdeling på Rikshospitalet tar et kraftig oppgjør med legestandens oppfatning av at høyt kolesterol fører til hjertesykdom. I et debattinnlegg i Aftenposten i dag legger han ikke fingrene imellom:

«Sannheten er nemlig at kolesterol ikke er et skadelig stoff. Det er faktisk et av de viktigste stoffene vi har i kroppen. Hjernen vår er avhengig av det, cellemembranene, som er vårt forsvar mot infeksjoner og kreftsykdommer, er avhengig av det», skriver Kjellevand og understreker:

«Å mene at dette stoffet er farlig, ja likefrem en 'silent killer', er så hinsides all fornuft at jeg ikke har ord for det.» (...)

Kjellevand mener myten om det farlige kolesterolet har fått leve videre fordi legemiddelindustrien tjener store penger på å selge kolesterolsenkende medisiner, såkalte statiner. (...)

Kolesterol - venn eller fiende
Av Tor Ole Kjellevand, overlege, Hjertemedisinsk avdeling, Rikshospitalet
aftenposten.no 19.8.2007
Under overskriften "Hva skal vi holde oss til?" har Knut Utstein Kloster et meget betimelig innlegg i Aftenposten 14. august. Sannheten er at så lenge Lipidklinikken og dens forkjempere får dominere mediene, vil sannheten ikke komme frem. (...)

Legemiddelindustrien lever høyt av å selge kolesterolsenkende medisiner, statinene. Det er en milliardindustri som man ikke er villig til å gi opp så lett. Så har man slike folk som driver Lipidklinikken, som lever av folks frykt for kolesterolet. (...)

Eksplosiv vekst i salget av kolesterolmedisiner
dagsavisen.no 25.7.2007
– Vi ligger på verdenstoppen i å behandle pasienter med kolesterolsenkende medisiner, sier hjertespesialist og avdelingsoverlege Steinar Madsen i Statens legemiddelverk.

I fjor var det over 360.000 nordmenn som fikk kolesterolsenkende medikamenter. (...)

Sterk vekst i salget av kolesterolmedisiner
vg.no 25.7.2007
Salget av kolesteroldempende preparater har i løpet av fire år økt med over 100 prosent. Dette er bra, mener Legemiddelverket. (...)

- Vi ligger på verdenstopen i å behandle pasienter med kolesterolsenkende medisiner, sier hjertespesialist og avdelingsoverlege Steinar Madsen i Statens legemiddelverk til Dagsavisen. (...)

- For lavt kolesterol kan føre til kreft
vg.no 25.7.2007
(VG Nett) Ved å redusere kolesterolet i et forsøk for å redusere faren for hjertesykdommer kan du øke faren for kreft, tror forskere. (...)

Specialists debunk statin link to cancer (Spesialister linker statin til kreft)
pharmatimes.com 24.7.2007
Heart patients were last night told to keep taking their statin tablets despite the emergence of data from the US suggesting that the cholesterol-lowering tablets might slightly increase users’ risk of cancer.

The study, published in the latest issue of the Journal of the American College of Cardiology had set out to examine how statins damage liver and muscle tissue. (...)

(Anm: Statins and Aortic Stenosis in the Context of Ratio of Low- to High-Density Lipoprotein. J Am Coll Cardiol.2007; 50: 289-290.)

(Anm: Low cholesterol linked with worse survival in patients with kidney cancer (medicalnewstoday.com 12.6.2014).)

Study links low cholesterol levels and cancer
today.reuters.com 24.7.2007
LONDON (Reuters) - The heart benefits of taking so-called statin drugs to reduce cholesterol might be offset by a slightly increased risk of cancer, although the evidence is by no means clear, U.S. scientists said on Tuesday.

A new pooled, or meta, analysis of past studies involving 41,000 patients on statins found one additional incident of cancer per 1,000 patients with low levels of LDL, or "bad" cholesterol, compared to those with higher LDL.

The results will be published in the July 31 issue of the Journal of the American College of Cardiology. (...)

Interaksjoner mellom statiner og makrolidantibiotika
Tidsskr Nor Lægeforen 2007; 127: 1660-1 (14.6.2007)
Det er beskrevet flere tilfeller av rabdomyolyse etter kombinert bruk av statiner og makrolidantibiotika. Nye hendelser kan forebygges med enkle tiltak, men det krever oppmerksomhet rundt denne typen interaksjoner i klinisk praksis. (...)

Does pravastatin promote cancer in elderly patients? A meta-analysis
CMAJ 2007;176 (5) (February 27)
Background: An increase in the incidence of cancer among elderly people assigned to pravastatin therapy has been reported in a randomized controlled trial; however, this finding has been attributed to chance. Our aim was to assess the effect of pravastatin therapy on cancer risk and to examine whether the effect varies according to age by performing a detailed meta-analysis and meta-regression analysis of randomized controlled trials. (...)

Interpretation: Our findings suggest an association between pravastatin therapy and cancer in elderly patients. However, given the importance of this potential association, further verification is warranted. (...)

Painkillers, cholesterol linked
newsday.com 13.2.2007
Vioxx, Bextra found to cause lipid buildup, possible risk to heart

Certain pain-relieving drugs that belong to a group of medications called COX inhibitors may impair the ability of human blood cells to rid themselves of cholesterol, according to research published Jan. 23 in the journal Arthritis Research & Therapy. (...)

Study Links Certain Painkillers to High Cholesterol Levels (Studie linker visse smertestillende legemidler til høye nivåer av kolesterol)
newsinferno.com 13.2.2007
A new study published last month in the journal Arthritis Research & Therapy sheds new light on why the class of painkillers known as COX-2 inhibitors may lead to an increased incidence of heart attacks. Researchers at Winthrop-University Hospital in Long Island have determined that controversial drugs such as Vioxx and Bextra may impede the body’s ability to purge excess cholesterol.

“To our knowledge, this is the first study that describes the effects of COX inhibition on reverse cholesterol transport proteins,” the authors wrote. “Our results suggest that the cardiovascular hazard observed with COX inhibitors may result not only from enhanced platelet aggregation [blood clots], but also from interference with cholesterol outflow.” (...)

Forbruget af kolesterolsænkende medicin eksploderer
berlingske.dk 29.1.2007
Medicin mod forhøjet kolesterol er et af de mest brugte lægemidler. 300.000 er i behandling mod 50.000 for fem år siden. Forbrugerrådet maner til forsigtighed.

Danskerne er gået til kamp mod kolesterol.

På et år, fra 2005 til 2006, er forbruget af kolesterolsænkende medicin steget med 30 procent, viser tal fra Apotekerforeningen.

Mere end 300.000 danskere var sidste år i behandling, og den udvikling glæder Hjerteforeningen. Her siger lægefaglig chef Mogens Lytken Larsen, at der i mange år har væren en tendens til at underbehandle patienter med hjerte-kar-sygdomme. (...)

Statin-related adverse events: a meta-analysis.
Clin Ther. 2006 Jan;28(1):26-35
CONCLUSIONS: Statin therapy was associated with greater odds of AEs compared with placebo but with substantial clinical benefit. Similar rates of serious AEs were observed between statin and placebo. (...)

Clinical perspectives of statin-induced rhabdomyolysis.
Am J Med. 2006 May;119(5):400-9
Fear of muscle toxicity remains a major reason that patients with hyperlipidemia are undertreated. Recent evaluations of statin-induced rhabdomyolysis offer new insights on the clinical management of both muscle symptoms and hyperlipidemia after rhabdomyolysis. The incidence of statin-induced rhabdomyolysis is higher in practice than in controlled trials in which high-risk subjects are excluded. (...)

Lawsuits Filed Over Lipitor Side Effects
washingtonpost 8.6.2006
NEW YORK -- Two men who believe they suffered lasting muscle damage from taking the popular anti-cholesterol drug Lipitor are suing medication's maker, Pfizer Inc., claiming the company didn't issue loud enough warnings about potential side effects.

Charles M. Wilson, a former insurance executive from Atlanta, and Michael Mazzariello, an attorney from New York City, said in separate lawsuits that they began experiencing debilitating pain, weakness and memory problems after taking the drug.

"It ruined my life," said Mazzariello, 47. He said that within weeks of going on the medication, he couldn't walk without a cane, tend his garden or lift his 1-year-old child.

The symptoms subsided once Mazzariello stopped taking the medication - he stood under his own power at a news conference Thursday at a Manhattan hotel - but he said he still suffers from pain, fatigue and a tingling sensation in his hands and feet.

Pfizer called the two suits "baseless" and vowed to fight them in court. (...)

UK cholesterol drugs policy 'ineffective'
netdoctor.co.uk 22.5.2006
The UK's policy on the use of cholesterol-beating drugs is not effective in reducing instances of heart disease, researchers have claimed.

Statins – drugs that cut cholesterol levels – are typically prescribed to middle-aged men and women who are deemed at high risk of developing heart disease.

However, in the UK their limited use is only resulting in a nine per cent reduction in heart disease cases, according to researchers writing in the journal Heart.

This is significantly less than the reductions achieved by the US and Europe where much greater statin use has resulted in drops in heart disease of 22 per cent and 19 per cent respectively. (...)

However the researchers, led by Professor Paul Durrington, admit that widespread use of statins in the hope of reducing heart disease rates "raises philosophical, psychological, and economic considerations".

Statins already cost the NHS more than any other prescribed drug – an average of over £150 per patient per year, costing a total of £769 million annually.

Detractors say that widening their use will therefore only increase the financial burden of the NHS. (...)

Effects of Early Treatment With Statins on Short-term Clinical Outcomes in Acute Coronary Syndromes
JAMA. 2006;295:2046-2056
(…) Data Synthesis Twelve trials involving 13 024 patients with ACS were included in the meta-analysis. The risk ratios for the combined end point of death, MI, and stroke for patients treated with early statin therapy compared with control therapy were 0.93 (95% confidence interval [CI], 0.80-1.09; P = .39) at 1 month and 0.93 (95% CI, 0.81-1.07; P = .30) at 4 months following ACS.

(…) Conclusion Based on available evidence, initiation of statin therapy within 14 days following onset of ACS does not reduce death, MI, or stroke up to 4 months. (...)

Foods lower cholesterol as much as medication
netdoctor.co.uk 9.3.2006
Eating a combination of heart-healthy foods can lower cholesterol as much as medication, according to new Canadian research.

According to researchers at the University of Toronto, eating a certain 'portfolio' of foods including fish, oatmeal, almonds and lean meats can help reduce artery-clogging LDL cholesterol as much as statin drugs.

The study, published on Wednesday in the American Journal of Clinical Nutrition, followed 55 overweight middle-aged men and women for a year.

It was found that after a year, one third of the group had lowered their LDL cholesterol by 20 per cent or more - a similar effect to that achieved by cholesterol-lowering statin drugs.

Another third that had followed the eating plan less strictly achieved an average reduction of 15 per cent, while those with the least compliance achieved an average of ten per cent.

The researchers hope that this will give patients a new reason to ask for dietary advice rather than medication at the first sign of high cholesterol levels.

"This study is exciting because it shows an effective dietary approach to lowering cholesterol isn't as hard or as intimidating as we previously thought it was," commented study co-author Dr David Jenkins.

"The patients who followed the Portfolio Eating Plan ate things that the average person eats every day."

The American Heart Association estimates that 99.9 million Americans have blood cholesterol values considered borderline-high risk to high risk. (...)

Kognitive bivirkninger ved statinbehandling?
irf.dk 7.6.2006
Konklusion
Store kliniske forsøg viser, at statiner ikke har effekt på kognitive funktioner. Kasuistikker medgiver dog muligheden for, at der i nogle sjældne tilfælde er sammenhæng mellem statinbehandling og kognitiv forringelse samt hukommelsestab.

Forskningsresultater omkring serum kolesterols påvirkning af hukommelsen er inkonstistente. (...)

Big Cholesterol Leads to Better Brains
ivanhoe.com (December 2006)
(Ivanhoe Newswire) -- When most people think of cholesterol, they think about high levels causing heart disease and stroke.

But research also suggests a role for cholesterol in longevity, and now investigators from Albert Einstein College of Medicine in New York have extended those findings by linking the substance to cognitive functioning in old age as well.

Cholesterol levels aren't the key factor, however. It's all about the size of the cholesterol particles. (...)

Studies: Statins Don't Lower Cancer Risk
abcnews.go.com 3.1.2006
Two New Studies Say Cholesterol-Lowering Statin Drugs Don't Lower Cancer
CHICAGO - Two new studies deal a double blow to hopes that cholesterol-lowering statin drugs could help prevent cancer as well as heart disease.

In one report, researchers analyzed 26 rigorous, randomized studies involving more than 73,000 patients and concluded that drugs such as top-selling Lipitor and Zocor had no effect on the risk of developing or dying from any form of cancer.

The findings appear in Wednesday's Journal of the American Medical Association. (...)

Lipidsänkning hjälpte inte hjärtinfarktpatienter
netdoktor.passagen.se 17.11.2005
Kraftig sänkning av blodfetterna hos patienter med hjärt-kärlsjukdom minskade inte risken för dessa att drabbas av ytterligare hjärtproblem. Det visar en stor europeisk studie som presenteras i den prestigefyllda medicinska tidskriften Journal of American Medical Association. 8888 patienter ingick i studien och samtliga av dessa hade vid studiens början haft hjärtinfarkt. Dessa fick lipidbehandling med antingen Simvastatin i normaldos eller hög dos av Lipitor. Resultaten visar att kraftig kolesterolsänkning, vilken åstadkoms men hög dos av Lipitor, inte minskade risken för ytterligare hjärtproblem. (...)

Lipitor or Generic? Billion-Dollar Battle Looms
New York Times 15.10.2005
The Lipitor war is about to begin.
Starting next June, insurers and government agencies will have the opportunity to save billions of dollars by moving patients from Lipitor, a cholesterol-lowering drug by Pfizer that is the world's top-selling medication, to an inexpensive generic version of Zocor, a similar but less potent drug now made by Merck. (...)

Pfizer Wins a Big One in Britain
businessweek.com 13.10.2005
A court rejects Ranbaxy's patent challenge to Lipitor, forestalling a generic version of the blockbuster. Next: A similar battle in the U.S.

Pfizer (PFE) investors are breathing easier. On Oct. 12, a British court handed the drugmaker a big victory, rejecting an effort by generic-drug maker Ranbaxy Laboratories to launch a generic version of Lipitor, Pfizer's $12.5 billion blockbuster cholesterol-lowering drug. (...)

- Statinvedtaket kom for tidlig
Dagens Medisin 18.8.2005
- Av helsemessige årsaker burde myndighetene ha ventet med statinvedtaket, sier Leiv Ose ved Lipidklinikken i Oslo.

Norske helsemyndigheter har vedtatt at simvastatin skal være førstevalg til alle pasienter som trenger medikamentell behandling av høyt kolesterol. (...)

Førstevalg
I Norge skal også pasienter som allerede står på andre statiner bytte til simvastatin dersom ikke tungtveiende medisinske grunner sier noe annet. Bakgrunnen er at simvastatin, som har gått av patent, er et billigere legemiddel enn atorvastatin slik at det vil spare samfunnet for store utgifter. Samtidig mener myndighetene at simvastatin gir god behandling.

Hvorfor dyrt?
- Vi har retningslinjer for hvor mye kolesterolet bør senkes. Hvis vi når de målene med et billig statin, hvorfor skal en da velge et langt dyrere legemiddel? spør avdelingsoverlege Steinar Madsen i Statens legemiddelverk.

- Simvastatin er bra og velegnet i veldig mange tilfeller. Av våre høyrisikopasienter vil cirka halvparten kunne ha hjelp av legemidlet. De andre bør ha atorvastatin i høyere dose, sier seksjonsoverlege Leiv Ose ved Lipidklinikken på Rikshospitalet.

Venter på IDEAL
Ose mener at statinvedtaket kom for tidlig.

- Vi mangler ennå data for å kunne fastslå at simvastatin er like bra som atorvastatin. IDEAL-studien, som legges frem på American Heart i november, kan resultere i resultater som gjør at man bør velge atorvastatin til store pasientgrupper. Av helsemessige årsaker mener jeg derfor at myndighetene burde ha ventet med vedtaket, sier Ose.

Ikke relevant
Steinar Madsen er ikke enig:

- Det vil alltid komme nye studier. Dessuten er slike studier gjort av industrien og er ofte utformet for å gi ett legemiddel en fordel på bekostning av andre. IDEAL-studien har målt et statin i høydose mot et annet statin i lavdose. Skulle det ha vært relevant i denne sammenhengen, burde man ha brukt maksimal dose av simvastatin sammenlignet med maksimal dose av atorvastatin.

Cholesterol Drugs May Harm Ill Diabetics
Washington Post 20.7.2005
-- Cholesterol-lowering statin drugs do not help severely ill diabetics, and may even raise their risk of a deadly stroke, a study found. In the study, patients on Lipitor were twice as likely to die of a stroke.

It was the first major test of statins in diabetics who need dialysis machines to remove wastes from their bloodstream because their kidneys cannot do the job. The results are surprising because previous research showed Lipitor helped less severely ill diabetics. (...)

Ezetimibe, muscle link highlighted
australiandoctor.com 10.8.2005 (Australian Doctor)
CONCERNS about muscle disorders linked to the lipid-lowering drug ezetimibe (Ezetrol) have been flagged in the latest Australian Adverse Drug Reactions Bulletin.

The Adverse Drug Reactions Advisory Committee drew attention to side effects such as myalgia, muscle cramps, weakness and pain associated with the drug in the August edition of the bulletin.

Forty-four incidents of muscle disorders have been reported to ADRAC since ezetimibe was registered in June 2003. In almost half of cases, the symptoms developed within two weeks of starting the medication. Twenty-one patients had a history of muscle disorders or increased creatine kinase associated with statin use. Myalgia and myopathy are listed as possible adverse effects of ezetimibe when used with statins. (...)

Study: Lipitor no better than rivals
The Associated Press/DUESSELDORF, Germany
Study: Lipitor no better than rivals
BusinessWeek 4.9.2005
SEP. 4 4:53 P.M. ET Pfizer Inc.'s cardiovascular treatment Lipitor, the world's best-selling drug, is no more effective than similar drugs and in some cases has worse side effects, according to a study by an independent German institute.

The results come from a survey of previous studies worldwide, rather than new clinical tests on patients. It was released Saturday by Institut fuer Qualitaet und Wirtschaftslichkeit im Gesundheitswesen.

IQWiG is an independent institution that studies value-for-money in health care, set up at the instigation of the German government. (...)

Pfizer Earnings Rise 21%, Exceeding Estimates
nytimes.com 21.7.2005
Pfizer reported earnings yesterday that exceeded analysts' estimates, on increased demand for medicines to treat the ailments of an aging population.

Net income at Pfizer, the world's largest drug company, rose 21 percent in the second quarter on higher sales of Lipitor, the cholesterol medicine.

Pfizer, which is based in New York, said its net income increased to $3.46 billion, or 47 cents a share, from $2.86 billion, or 38 cents, a year earlier. (...)

Papers Indicate That Bayer Knew Of Dangers of Its Cholesterol Drug
nytimes.com 22.2.2003
Newly disclosed company documents indicate that some senior executives at Bayer were aware that their anticholesterol drug had serious problems long before the company pulled it from the market.

The documents, made public by lawyers suing Bayer, include e-mail messages, memos and sworn depositions of executives that suggest that Bayer promoted the drug, Baycol, even as a company analysis found that patients on Baycol were falling ill or dying from a rare muscle condition much more often than patients on similar drugs.

The lawyers are suing Bayer, which is based in Germany, and its British marketing partner, GlaxoSmithKline, in federal court in Minneapolis and in dozens of other cases around the country. Though the documents do not paint a full picture of what the companies knew, or how early they knew it before Baycol was pulled from the market in 2001, they provide a rare glimpse inside a major drug company's marketing efforts in the face of mounting indications of trouble. (...)

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