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Dr Perry raises a good point, with his proposal for "a large experiment to explore this issue (of statin adverse effects)", but we already have a reasonable proxy when we look at total patient dropouts in control vs treatment arms of statin trials. For example, as I noted (1) in a critique of the IDEAL Study (2), "While neither the primary end point of the study (all-cause or cardiovascular mortality) nor the outcome of serious adverse events reached statistical significance, 3 outcomes that did reach significance were drug discontinuations due to diarrhea, abdominal pain, and myalgias." In other words, IDEAL demonstrated that with HIGHER dose statin treatment, more patients stopped treatment due to adverse events, whether or not those events fit the pre-specified categories investigators were looking for. We need to watch for the UNEXPECTED, not just the expected.
(1) Cayley WE Jr. High-dose statins and the IDEAL study. JAMA. 2006 Jun 7;295(21):2476
(2) Pedersen TR, Faergeman O, Kastelein JJP. et al. for the Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) Study Group. High-dose atorvastatin vs usual-dose simvastatin for secondary prevention after myocardial infarction: the IDEAL study: a randomized controlled trial. JAMA. 2005;294:2437-2445