Talk:Statin

Decreasing of specific protein prenylation

I added a subsection under Mechanism of Action related to inhibition of isoprenoids / protein prenylation, which recent research increasingly suggests plays a significant role in the efficacy of statins.

One reason these findings are of such consequence from a research perspective is that statin-induced cholesterol reduction simultaneously serves as a marker for inhibited protein prenylation while patients are under statin therapy (given the HMG-CoA reductase pathway) -- and this shared inhibition has potentially large implications when (re-)interpreting much of the research to date with statins. In addition, the inhibition of protein prenylation may, at least in part, explain: (1) the considerable efficacy of statins in preventing cardiovascular disease where a number of other cholesterol-lowering modalities/medicines have failed to produce such dramatic benefits and (2) the surprising dose-dependent reduction by statins in cardiovascular events when cholesterol is already low (or driven low). The overall finding as to the relevancy of protein prenylation as part of the mechanism of action of statins is more than worthy of mention in the article, and I kept the addition succinct. Bdmwiki (talk) 07:01, 20 November 2013 (UTC)

[Jmh649, would you please explain why you keep removing this subsection, so we can arrive at a better understanding? Per Wikipedia: "The question of whether source material is secondary or primary should not, however, become a focal point for edit warring...It is therefore important to remember that, according to policy, primary, secondary, and tertiary sources may all be acceptable if used appropriately."] — Preceding unsigned comment added by Bdmwiki (talk • contribs) 17:09, 8 November 2013 (UTC) (modifed — Preceding unsigned comment added by Bdmwiki (talk • contribs) 07:36, 17 June 2015 (UTC) )

note, i removed "cataracts" as there are no reviews on this - see here Jytdog (talk) 12:36, 17 June 2015 (UTC)

Here is a later 2002 second study re cataracts, statins, and prenylation- "Geranylgeranyl pyrophosphate counteracts the cataractogenic effect of lovastatin on cultured rat lenses."(pmid 12457872) And of course, cataracts are a well established concern for statins (e.g., http://www.webmd.com/cholesterol-management/news/20141205/daily-statin-might-raise-your-risk-for-cataracts-study), so the potential causative role re prenylation seems significant. I'm not sure why a review is a prerequisite for inclusion in Wikipedia with two good studies and am hoping you could explain. I won't go to war over this one edit, but it seems noteworthy that there is a basis in reduced prenylation for the primary side effects of statins, including cataracts.Bdmwiki (talk) 18:48, 17 June 2015 (UTC)

I found 3 primary sources and associated hype about of each of them like the webMD source you found. Again, not a single review discusses this. Jytdog (talk) 18:54, 17 June 2015 (UTC)

origin of the name?

i am surprised not to see an etymology of the name of this group Feroshki (talk) 23:49, 11 November 2013 (UTC)

Have a source? JFW | T@lk 16:15, 11 February 2014 (UTC)

Suggested expansion of the article to merge or include the history of cerivastatin

It appears that the relative potency of one statin head to head against another is about to become profoundly relevant. I think this article would benefit from a minor expansion that includes the rise and fall of cerivastatin. Cerivastatin was engineered (and succeeded) to be the most potent statin yet devised and was trotted out in daily doses of just 0.4 and 0.8 mgs. One could still soundly reason that what happened to cerivastatin is a class effect and can still be extrapolated to all the others within it. Well documented encyclopedic illumination of this dark corner in the history of statins may help balance the anticipated explosion of information forthcoming. Those favoring the "megastatins" do this at their peril. Wikipedia is well poised to document this as it unfolds. --lbeben 00:08, 14 November 2013 (UTC) — Preceding unsigned comment added by Lbeben (talk • contribs) 00:08, 14 November 2013 (UTC)

Combination therapy

doi:10.7326/M13-2526 Systematic review discussing whether combination therapy is better than increasing doses of statins. No long-term endpoints, but some data supporting combination with ezetimibe or bile acid sequestrants. JFW | T@lk 16:15, 11 February 2014 (UTC)

Blogs

I have removed the blog / popular press in this edit [1]. If Ben Goldacre wishes to update his paper he must do so the usual way. We cannot use an "update" published in the Guardian. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:20, 15 March 2014 (UTC)

Bias in studies related to particular drugs, no bias in general efficacy

In an editorial in the BMJ Bero found a bias favoring the drug from the sponsoring company in studies of statins. This was in response to a study by Naci that found "the findings obtained from industry sponsored statin trials seem similar in magnitude as those in non-industry sources."

I'm not sure how (if) this should be included.

References

- - MrBill3 (talk) 04:06, 4 October 2014 (UTC)

I'd argue for leaving it out. Editorials are not the greatest of sources (probably not peer reviewed, for example). Even if the source were ideal, it seems like an issue that is more about the industry or about specific drugs than about statins as a class, and the article is about the class. Formerly 98 (talk) 04:16, 4 October 2014 (UTC)

It is a commissioned editorial in the BMJ so although not peer reviewed it carries some weight. I tend to agree as the article doesn't delve too deeply into particular brand name drugs. Also the study it comments on and the editorial itself seem to clearly indicate that studies into statins are not biased in terms of the cholesterol lowering effects of statins as a class. Just wanted to make the info I have access to through the WP Library available. Thanks for the input. - - MrBill3 (talk) 04:31, 4 October 2014 (UTC)

Editorials are peer review. WP:MEDMOS says that reliable sources are articles published in peer-reviewed journals. It doesn't say that the only reliable sources are peer-reviewed articles. --Nbauman (talk) 13:05, 17 February 2015 (UTC)

MEDRS calls us to use secondary sources (reviews and statements by major scientific & medical bodies) and makes a clear distinction between editorials and reviews. please see the first paragraph of Wikipedia:Identifying_reliable_sources_(medicine)#Biomedical_journals which says "Peer-reviewed medical journals are a natural choice as a source for up-to-date medical information in Wikipedia articles. They contain a mixture of primary and secondary sources. Journal articles come in many types, including original research ranging from vast studies to individual case reports, reviews, editorials and op-ed pieces, advocacy pieces, speculation, book reviews, letters to the editor and other forms of commentary or correspondence, biographies, and eulogies. It is usually best to use reviews and meta-analyses where possible. Reviews in particular give a balanced and general perspective of a topic, and are usually easier to understand." Editorials are very much PRIMARY sources, and the policies WP:OR and WP:NPOV along with RS and MEDRS call us to use secondary sources. Jytdog (talk) 14:21, 17 February 2015 (UTC)

CTT results

The CTT has reported again, this time for 174,000 individual patient data sets. doi:10.1016/S0140-6736(14)61368-4.

• Lowering LDL-C by 1 mmol/l reduces vascular event rate by 16% in women and 22% in men.
• All-cause mortality is reduced by 9% in women and 10% in men, both with a wide-ish confidence interval.

We ought to present this data in the article, perhaps through replacing other references that are older & outdated. JFW | T@lk 12:07, 9 January 2015 (UTC)

Yes agree. Doc James (talk · contribs · email) 16:29, 9 January 2015 (UTC)

Dosage

If there is a general consensus as to what constitutes "low","high" and "intensive" dosage levels, it would be nice if the dosage-equivalency chart could be enhanced to indicate these ranges, since they are used when describing benefits and side-effects.(71.233.167.118 (talk) 06:06, 20 April 2015 (UTC))