Letters JUPITER study

JUPITER may yet change practice

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a2921 (Published 10 December 2008) Cite this as: BMJ 2008;337:a2921
  1. Mikael Rabaeus, medical director1
  1. 1Health Management Centre, Clinique de Genolier, 1272 Genolier, Switzerland
  1. mrabaeus{at}genolier.net

    Donner-Banzhoff and Sönnichsen temper the hype following the publication of the JUPITER trial,1 but other issues are also problematic:

    • It is hard to find a good reason to stop the study early, given the low absolute benefit

    • The mortality data show an even lower absolute reduction of 0.25% (number needed to treat (NNT) 400). Curiously, a short time before the study was interrupted the reduction was only around 0.1% (NNT=1000)

    • The competing interests are staggering. For example, the first author and chair of the steering committee is a co-inventor of the high sensitivity C reactive protein test, which has been licensed to AstraZeneca.

    JUPITER should simply be discarded as irrelevant and at best doubtful in its conclusions. In fact, it could be regarded as evidence that statins are probably much less effective than we want to believe. Indeed, in the CORONA trial rosuvastatin compared with placebo showed no benefit on clinical outcomes in high risk patients with heart failure.2 Perhaps JUPITER will make us consider carefully whether our patients really need statins.

    Notes

    Cite this as: BMJ 2008;337:a2921

    Footnotes

    • Competing interests: None declared.

    References