Statins May Halve Heart-Attack Risk

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UPDATE 3.28.23: Beware the marketing of cholesterol-fighting drugs. A new cholesterol-fighting drug, bempedoic, branded Nexletol, is using a similar marketing strategy as statins. Here from Oregon Live’s Joe Graedon, M.S., and Teresa Graedon, Ph.D., is some revealing information about the marketing surrounding this new cholesterol-fighting product:

Dear Joe and Teresa Graedon: I’ve been reading about bempedoic acid as an alternative to statins to prevent heart attacks. It is marketed under the brand name Nexletol. I hope you can interpret the results of the recent study for your readers.

The authors report a 23% lower risk. I believe that is a relative risk number, which is most useful for marketing expensive drugs. I would like to know the absolute risk reduction. Can you enlighten us?

A. Thank you for this very sophisticated question about the recent study (New England Journal of Medicine, March 4, 2023). Most of the news reports about bempedoic acid have emphasized the 23% relative risk reduction in heart attacks. That certainly sounds impressive.

Drilling down on the data, however, reveals that 3.7% of people taking Nexletol had heart attacks during the more than three years of the study. In comparison, 4.8% of those on placebo had heart attacks. That absolute difference is 1.1%.

When it came to survival, the two groups cannot be told apart. Of those on the medication, 6.2% died from any cause. That is almost identical to the 6.0% who died while taking placebo.

According to GoodRx, a month’s supply of Nexletol could cost over $460. That makes it substantially pricier than statins unless insurance covers it.

Originally posted May 7, 2012.

This archived Time article recently caught my attention. Halving heart-attack risk would sure be a welcome result. The article noted the following:

• 17,800 people were tracked in the study.
• Half (8,900) were given a placebo.
• Half (8,900) were given the statin drug Crestor.
• Over about two years, the article notes, 31 statin-takers suffered a heart attack.
• When compared to the placebo group, the figures translate to a 54% lower risk of heart attack.
• It would thus calculate that perhaps 67 non-statin takers suffered a heart attack.
• Thus 36 heart attacks were potentially prevented.
• The NNT (number needed to treat): 8,900 people needed to be treated to prevent 36 potential heart attacks.
• It can thus be calculated that 247 people needed to be given Crestor to potentially prevent one heart attack.

And the headline reads that heart attack risk was halved! What’s your read?

A 247 NNT holds little appeal for me. How about you?

I would be interested in what side effects occurred for the entire 8,900 Crestor takers.