Episode 111: PREMIUM – New stuff you really need to know about
In episode 111, Mike and James bring you the premier edition of the new PREMIUM TEC podcast episodes. We discuss high dose versus low dose statins, we possibly put the final nail in the rosiglitazone coffin and finally report that single high annual doses of Vitamin D didn’t do what they were supposed to do.
Comments
statin trials
I wonder if the reason for more statin trials is the push by the drug companies to have everybody on the highest dose or newest statin available. Our local cardiology department puts everyboy who comes in with acute coronary syndrome and who is already on a statin on atorvastatin 80mg. The price difference between simvastatin 40 and atorvastatin 80 is roughly 30fold. When we inquired about the evidence-base we were quoted a small study that showed a marginal benefit. Extrapolating from that we worked out with the numbers needed to treat it would cost the British taxpayer £144 000 to avoid one extra death.
Or am I just being cynical?
Keep up the great work.
Ralf
glitazones
I think that this is where the drawing board and all of our "training" actually hurt us. The glitazones and their mechanism of action is a very pretty picture (ppar gamma). Metformin and its inhibition of gluconeogenesis doesn't make much sense in a well oiled krebs cycle and oxidative phosphorylation, etc... However, in real life, metformin is way better than those drugs. That's why clinical benefit is so important. Just like using bromocriptine to lower A1c... really?
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