Heart Drug 'Hype'? Docs Debate Crestor
Some Physicians Say Last Month's Enthusiasm Has Not Led to Change in Practice
Cardiologists were perhaps the most enthusiastic over the results. In an online poll conducted by the website Cardiosource last month, most respondents said they would measure CRP in at least some of their patients. Some cardiologists already use CRP to help them decide whether to prescribe statins to patients who already have certain heart risk factors; for them, JUPITER was one more piece of evidence that CRP testing could save lives.
"CRP is like a barometer of all the different risk factors," says Cardiosource editor Dr. Christopher Cannon, associate professor of medicine at Harvard Medical School and senior investigator in the TIMI Study Group.
And while non-cardiologist doctors tended to be somewhat more divided on the issue, many still anticipated that the research would make waves in clinical practice. Following the release of the study, the New England Journal of Medicine Web site polled medical professionals on whether they felt doctors should change their practice because of the study.
Of the more than 2,500 responses were received, 49 percent said the findings should affect laboratory testing, and 48 percent said statin drugs should be used differently in the wake of the trial.
Still, the drug is not without its risks. Side effects of the drug, which can range from mild to severe, include muscle and liver problems, as well as an increased risk of diabetes.
And some physicians say the fact that the trial was stopped early could have masked safety problems that may have occurred later on.
Critics also point out that while rosuvastatin cut rates of heart attack, stroke, and heart-related deaths by nearly half, very few of those not taking the drug -- less than 2 percent -- actually suffered these conditions. In short, it appears that the vast majority of people taking the drug would not have had these problems anyway.
"The [risk] reductions were actually tiny -- less than 1 percent reduction," Prine said.
So while the study authors claim that one life may be saved for as few as 25 patients treated with rosuvastatin, some say that many more patients -- and wallets -- will be affected if CRP screening to determine who should take rosuvastatin becomes routine.
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