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No Difference Between Statin Drugs

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The statin smackdown contest between Crestor and Lipitor is a draw. At least that is the conclusion of a new study that pitted high doses of both cholesterol-lowering drugs. Over a thousand patients were randomized to either Crestor or Lipitor. Investigators compared the thickness of the plaque in the coronary arteries. After two years they found it had shrunk by about 1 percent in both groups. The study was not designed to show whether patients would be less likely to have heart attacks. Since both drugs performed about the same, insurance companies are likely to prefer the less expensive medication, now that Lipitor is about to go off patent.

[New England Journal of Medicine, Nov 15, 2011]

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Two years of meds for 1% shrinkage of plaque? Is that a significant enough result to warrant continued taking of the drug? Hope those 1,000 patients don't have significant side effects.

The above test measured plaque but didn't mention LDL, HDL or total cholesterol! WHY? These parameters were surely measured. (I may try to wade through the cited New England Journal of Medicine article to verify the presence or absence of these measurements that so many people are medicating to change.)

I had a full cardiologist stress test in Feb 2011 and was heart healthy (age 73). I have had one TIA stroke in 2002.
I know the following is not a dbl blind test or even close but, to me, it says that there is a difference, important to some people, between Lipitor and Zocor.

After my suggestion to try no Zocor at all, my Dr. (an internist) and I recently agreed to change me from 40mg generic of Zocor/day to 10mg Lipitor. After about 2 months, I had another fasting cholesterol test and found that my total cholesterol had gone up from 135 to 179 but my HDL had also gone up from 35 to 42.

Then I mentioned to my Dr. that the leg pains and cramps which started after I started Lipitor were somewhat troubling me when I walk my dog every day. I knew that leg pain is a complaint of Lipitor so I may have been hyper-vigilant. We decided to try Niacin with no statins at all. I am now working up the dosage and am currently at 1000 mg/day, with no flushing so far. I think the goal is about 4000 mg of niacin a day but I guess it will depend on the next cholesterol test (early Jan 2012).

Note above that EVEN though I reduced statin dosage from 40 mg of Zocor generic to 10 mg of Lipitor, my HDL went up a significant (to me) good amount. If not for the leg pain, I think the 10 mg dose of Lipitor would have been a medical improvement for me. Cost to the almighty insurance co. (and to me) was higher but soon to reduce when the generic of Lipitor comes on market.

I look forward to reading further comments on the above posting.

My husband was on Lipitor and started experiencing leg cramps and muscle weakness along with difficulty walking. We asked for an alternative med and he was put on Crestor. His problems persisted over a period of time and eventually led to such severe leg pain that he had to resort to a walker at times. He was also diagnosed with spinal stenosis and told all his problems were from the stenosis.

He had surgery (an "x-stop implant") and his walking improved to the extent that he could shuffle along without the walker, but the pain in his thigh muscles was still there. We were repeatedly told there was no connection between his meds and his pain, and although we asked, we were told there was nothing else available. In frustration, he stopped taking the Crestor for a month, and behold, he felt better, the pain subsided and he was able to walk much better.

However, his blood tests were horrible: Cholesterol shot up to 375 and tris went to 1568! He was put on Gemfibrozil, 600 mg, twice a day, and guess what! His levels dropped to within normal range AND his leg pain is gone. Gemfibrozil is an old med and is NOT a statin. So, why wasn't he put on this a long time ago? It is doing the job and he feels well. We are in the process of looking for a new doctor. Too many years of suffering with closed-minded doctors has taken its toll.

I'm curious what your thoughts are on going holistic only to acquire healthy cholesterol levels and stop statins altogether. Recently lost ins. and the statins will be costly. I am considering CO-Q10, Niacin and Krill Oil also on better diet.

Is Lovastatin just as effective as Crestor or Lipitor?

Also 1% improvement does not seem very much. Is it statistically a beneficial number?

Does the 1% mean that at least the plaque is not getting worse? And since this is a group average then does it mean that some of the group have no improvement and some get increased plaque with any of these plaque fighting medications?

I did read as much as I needed of the New England Journal of Medicine article. It told me that this study is not very meaningful to me (and probably not to anyone. The study was funded by AstraZeneca, maker of Crestor. Of course, it's written to indicate that Crestor is BETTER than Lipitor. I guess they want people (their doctors) to quickly change to Crestor before Lipitor goes generic and is cheap.

As L.J. said above, 1% shrinkage of plaque is not very meaningful for a 2 year study. When I read the study, the difference between the 2 meds was very slight. Both produced good but essentially equal LDL and HDL levels, and then it shot big pharma in the foot with the 1% plaque improvement. I wonder if AstraZeneca fired some people over that. Someone who is not funded by big pharma needs to do a smaller but similar study with generic statin (simvastatin), and other cheaper meds including niacin This cholesterol scare has gone on for a long time, making big pharma rich.

My son was on a statin for a few months. He suffered terrible muscle pain. One day he called me from his office in tears, to come take him to his doctor. He could not even put the car keys in the ignition to start his car. His muscles had been so compromised that he was unable to function. The doctor took him off the statin and soon his muscles returned to normal. He was in his mid thirties when this happened.

My very savvy nurse practitioner prescribed CQ-10 WITH the Zocor. Leg pains stopped. When I reduced the dosage of the CQ-10 the pains started again. Since I've reduced the statin, it is possible to reduce the enzyme. You have to play around with it to get the right dose.

You can now get a drug card from the Lipitor manufacture it will only cost you 4.00. The drug is ready to go off patient. This is good for one year. Check it out.

https://www.lipitor.com/patients/LIPITORforYou.aspx

As I mentioned above (Nov 18, 2011), I had changed from 40 mg Zocor (with Tot. cholesterol of 135 but HDL 35) to 10 mg Lipitor (with Tot. ch. of 179 but HDL 42 and then, because of leg pains, to 1000 mg niacin only.

My fasting blood test on Feb 1 showed: HDL up to 50 (good), LDL up to 176 (BADDD!) and total cholesterol up to 245 (BADDD!). In a short note above these test results, she sugested Zocor + Zetia. - I had had good results with Vytorin 40 for several years, then switched back to just Zocor 40 for several years resulting in HDL of 35 which is bad but good LDL of 135. I really don't want to go to the Zetia added drug. I'm trying to get away from this poorly tested stuff as much as seem safe to me (but I did have a TIA stroke in 2002).

Now I am waiting to see what my Dr. says to my tentative suggestion (via phone call to her nurse) that I try 20 mg Zocor along with the 1000mg Niacin. Of course, I haven't heard of any testing or reports on the effects of loading up on 1000 mg of niacin daily for long periods.

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