IESIOSIERONE

IESIOSIERONE For many that gamble is the possibility of side effeCtS. A study and subsequent article in the BMJ questioned the data behind the NICE recommendations, warning that some trials included in the analysis were funded by statin manufacturers and that data on side effects was lacking. Patients taking statins often anecdotally report muscle pain. although this has not been seen in the major, placebo-controlled trials. The BM] article said that one in five people on statins experiences a side effect of some kind, altnough It later withdrew this claim after Rory Collins at the University of Oxford, a leading statin researcher. spoke out against the fat EVEI? heart attack prevented, accuracy of the statistics. Yet the anecdotal reports continue mote people will be toil statics to surface. -Some doctors say they keep seeing patients with the same complaint and they feel its due to the stab n: says David Preiss of the University 01 Glasgow. It doesn't look that way from the trials. but we need a better answer." There does seem to be a link to diabetes. Preiss has studied the connection between statins and type 2 diabetes. He says taking a medium-dose statin raises your risk by 10 per cent. and the risk continues to rase in line with dosage. These are modest changes - people who are probably already on the trajectory to diabetes, and the stain pushes them over the threshold." In light of all the concerns. Collins's. undertaking a major renew of the data on side effects, which he hopes will reassure people. That's important, he says, because fears over statins are discouraging people from taking them. to the detnrnent of their health. The results should be out later this year. In the meantime. if you've ever had a heart attack or stroke, you should be on a stain it possible, says Preiss. "And if you haven't, but you've been shown to be moderately or markedly at risk of having a heart attack, the benefits of a statin considerably outweigh any risks." No one should pin all their hopes on a pill in any case. Taking stators should be accompanied by lifestyle changes such as taking exercise and giving up smoking. RO hBOCIII . „ What they popped The percentage of adults taking the commonest types of prescription drugs is rising, according to a US Survey ■ 1994.1798 MI 2007.2010 18.64 years Antidepressants Analgesics Anticoaglants Arthdiabetics Anti-acid reflux Cholesterol-Icnsering Cardiovascular 65 years and over antidepreSSants AnalgeSics Anticoagulants Antidiabelics Anti-acid reflux Cholesterol-lowering Cardiovascular I I I I. 6 LB 116 16.6 0 23 4.0 E3 80 Per cent If the adverts arc to be believed. testosteron supplements are a cure-all for men facings unfortunate effects of middle age.lhe hormone is claimed to improve muscle strength, energy and sex drive. However, not only is there little evidence for this, several studies have found a link with heart disease. Trad I t lonally, testosterone was prescribed to men with abnormally low levels due to a congenital condition or damage to the testes from chemotherapy. Now, though, middle- aged men are being prescribed "testosterone replacement therapy" (T 'l') to make up for t natural decline that often comes with age. In the US, the number of men being prescribed testosterone rose from 1.3 million 2.3 million in the five years up to 2013, and the UK has seen a similar trend, although the numbers are far lower (see graph, below right): But in March. the US Food and Drug Administration cautioned that testosterone should only be prescribed to men with low levels caused by medical conditions, rather than general ageing, and confirmed by a lab test. The European Medicines Agency has issued a similar statement. The health bodies also asked manufacturers and prescribers of testosterone products to warn users about a possible risk of heart attacks and strokes after a number of studies showed an association. One trial was even term inated early due to an `excess of cardiovascular events" among participants. Worryingly, a 2013 analysis found that the level of cardiovascular risk reported varied. depending on whether the study was funded by the pharmaceutical industry. One possible mechanism for testosterone's effect on the heart could be through raising the number of red blood cells. which thickens the blood and can lead to dangerous dotting. Another worry is prostate cancer, which feeds on testosterone: drugs blocking testosterone are sometimes used to stop the cancer spreading. A meta-analysis published in 2014 found no link with Tat In the short term. but called for more long-term data. "There's an absence of data on the use of testosterone outside its key clinical application and yet someclinicianenthusiasts, particularly private practitioners In the US. have just exploded testosterone prescribing to the point where it's almost become mainstream." says Richard Qu inton. an endocrinologist at Newcastle University, UK. Pan of the problem. at least in the US, is that men are not being properly tested before start I ng treatment, says Sander Greenland all epidemiologist at the University of California, 321NewSPentist 116 stay 2015 EFTA01069456