Risks in the balance: the statins row

Imagine, if you will, a patient newly prescribed a statin by his general practitioner: let’s call him Mr Lowrisk. It is Thursday 15 May, and as Mr Lowrisk sits down to breakfast the Today programme on BBC Radio 4 is broadcasting a discussion about the risks and benefits of statins. He listens carefully—a golf partner has warned him that statins can make your muscles ache. Defending statins, Rory Collins, an Oxford professor, asserts confidently, “There is a very, very low risk of muscle problems,” a reassuring message for Mr Lowrisk. On his way to work he picks up his prescription, and at coffee time he reads the patient information leaflet.

To his surprise, listed under common side effects that may affect “up to one in 10 people” are joint pain, muscle pain, and back pain. “But I thought that professor said there was a very, very low risk of muscle problems,” he mutters. Mr Lowrisk is confused. The manufacturers seem to be owning up to a side effect that the Oxford professor said barely even existed.

This vignette, oversimplified as it may be, encapsulates an argument over the risks and benefits of statins that has been raging ever since The BMJ published two articles on the subject in October last year.1 2 The reputation of the journal has been called into question; so has that of the authors responsible, charged by Collins with deliberately misconstruing the evidence and unfitted, in his view, from ever contributing to the journal again. Comparisons have been drawn, again by Collins, with the scare over the measles, mumps, and rubella vaccine, in which parents were discouraged from getting their infants vaccinated by false evidence linking MMR …