The New York Times has reported that doctors are facing a dilemma in regards to prescribing statins. Statins are medications lowering cholesterol thus decreasing the risk of cardiovascular disease. Coronary artery disease accounts for 1 in 7 deaths in the United States.
Currently about 1 in 4 adults are prescribed a statin. This medication blocks an enzyme needed to produce the bad cholesterol, LDL. Unfortunately 25 % of those who take statins have side effects including liver function abnormalities, muscle aches, memory issues, and sleep problems.
In late August of 2015, two new medications, Praluent and Repatha have been released that supposedly do not have these side effects. They lower cholesterol without as many side effects but cost around 14,000$ a year. The dilemma is this; should physicians commit those who have side effects on statins, no small number, to these new, expensive and relatively untried medications?
To make matters more complicated is the statement made in June of 2015, Richard Horton, the editor of Lancet wrote, “Much of the scientific literature, perhaps half, may simply be untrue. “He goes on to write, “with small sample sizes, tiny effects, invalid exploratory analysis and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn toward darkness.” This is from a scientist who is on the front lines. Dr. Horton as editor of a prestigious Journal is on the front lines of evaluating scientific research. Unfortunately he is not alone in skepticism regarding scientific studies. Dr. Marcia Angell, former editor in chief of the New England Journal of Medicine in 2009, states, “It is no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative guidelines.
Which raises the question, what should a patient, physician, healer, or the general public believe? Is a randomized double-blinded placebo trial enough? I personally wrestle with this question daily as people ask about medications, treatment, and supplements.
I start with James 1:5 and ask for wisdom from the Great Physician. Then, I see if there are any Biblical prescriptions relating to the question at hand. I ask does this treatment make sense? I go to other trusted sources and look at whatever evidence-based sources are available paying attention to funding and professional bias. Then I observe the test of time. Truth is a stubborn thing. It does not go away.
What to believe will be an ongoing question. Let the evidence speak!