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The Role of Surrogate Markers In The Statin Debate

Cholesterol-lowering therapy sure has been taking a beating lately.  For manysurrogatemarkers.jpeg years, it was accepted that cholesterol medications are good because they reduce “bad” LDL cholesterol.  Over time, lowering LDL would lead to fewer heart attacks and strokes, which is a good thing.  

However, recently some have been preaching against this gospel.  The premise of a widely-cited BusinessWeek article was that statins do little for people without pre-existing heart disease.  

In addition, we have the furor over the ENHANCE trial. Overall, the study failed to show that the combination drug Vytorin had any influence on the build up of fatty plaques in the arteries.  Arterial plaque is a major (and physical) indication that a person is at risk for a heart attack or stroke.

While these studies have generated a lot of attention, what’s more interesting is what they tell us about the ability of surrogate markers to predict death and disease.  Surrogate markers like high cholesterol and hypertension are commonly used to indicate whether a person has a higher risk of dying from heart disease.  However, it is important to note that the relationship between a surrogate marker and the ultimate endpoint of death is often not linear.   


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FDA DTC User Fees: Dead In The Water
Last week, the FDA announced that its controversial direct-to-consumer advertising user fee program was being discontinued.  The reason: lack of funds.  Another: A less than enthusiastic response from the pharmaceutical industry. According to “When President Bush signed the Prescription... Continue Reading
Tanking Stocks + Credit Crunch + Recession = Fundamental Health Reform?
In a surprise move, the Federal Reserve Bank cut a key short-term interest rate this morning to 3.5%.  This cut occured to help reassure the markets after a global sell off of US stocks yesterday.  This move, is the latest... Continue Reading
Talking Health 2.0 With Cary Byrd
Cary Byrd of is running an interview series about Health 2.0.  I'm honored he asked me to particpate.  Click here to read my interview with him and some interesting thoughts by several intriguing folks. ... Continue Reading
Spend $300 & Find Out Your Prostate Cancer Risk; Great News, But Something Is Missing
Today, the New York Times reports that a company formed by Wake Forest Researchers, ProActive Genetics, has developed a test that will enable men to find out whether they are at an increased risk of prostate cancer.  According to the... Continue Reading
The Coming War Over Healthcare (Hint: It’s Not The One You Think)
Currently, the airwaves are saturated with news of the presidential candidates’ efforts to woo voters and earn a shot at the nation’s highest office.  Their speeches (and the media) have given everyone the impression that the new president will offer... Continue Reading
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Classic Post 3: British Cyberchondriacs Skip Canned Content & Ads, Favor Personal Stories
Read this post about an influential British study that revealed why people prefer peer-developed content.... Continue Reading
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Classic Post 2: Depression Education, Cause Alliances & Social Media Communications -- Part I
Read this post, part of a six-part series, for commentary on the issues surrounding drug industry support of non-profit organizations. ... Continue Reading

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