Has Professor Collins’ call for BMJ ‘statin’ papers to be retracted backfired spectacularly?

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Professor Sir Rory Collins is one of the most strident advocates of statin therapy, and also leads a ‘research group’ known as the Cholesterol Treatment Trialists collaboration (CTT). Professor Collins and his colleagues hold a huge database of from statin studies, and quite-often ‘crunch the numbers’ and pronounce statins to be highly effective and very safe.

Previously, I have written about the attempts by Professor Sir Rory Collins to have two articles in the BMJ withdrawn. Both of them cast considerable doubt on the effectiveness of statins, particularly for those at relatively low risk of cardiovascular disease. However, both pieces also misquoted a piece of research finding that statins were associated with adverse effects in 17.4 per cent of those who take them. Both articles rounded this figure up to 18-20 per cent, and also implied that statins caused the adverse effects seen (the study – ‘observational’ or ‘epidemiological’ – type did not allow this inference to be made).

Once alerted to the issue, the BMJ promptly withdrew the comments about adverse effects. But Professor Collins was not happy, and insisted that the BMJ retract both articles in their entirety. However, to my knowledge, neither Professor Collins not anyone else had countered the main thrust of the articles (one was principally about the ineffectiveness of statins, and the other was the lack of association between saturated fat and heart disease).

The editor-in-chief of the BMJ – Dr Fiona Godlee – convened a committee to look into the matter, and to rule whether there were grounds for the one or both of the articles to retracted.

Elsewhere in the BMJ, one of Professor Collins’ previous collaborators – Professor Peter Sever – referred to Professor Collins’ detailed case for retraction. I emailed Professor Collins asking if I could see his detailed arguments. I was particularly interested to read what Professor Collins’ had to say about the claims that statins are, on the whole, quite ineffective. To his credit, Professor Collins replied, but only to tell me I would need to wait until the committee issued their report and all the documentation.

Well, last week, the committee published their report. It found no grounds whatsoever for retraction of either of the articles. You can read the report here, and here is a list of all the relevant documentation.

I read four (SP17-20) letters Professor Collins submitted to Fiona Godlee to make his case. Each letter, I think, has a similar theme: the claims about statins side effects were inaccurate and overblown, and as a result people may be discouraged from taking them or continuing them (exposing them to increased risk of cardiovascular disease). However, these issues had been acknowledged by the BMJ and the authors of the articles, and the statements had already been withdrawn.

However, on the subject of the effectiveness (actually, ineffectiveness) of statins, Professor Collins has nothing much to say. My guess is that Professor Collins would prefer not to engage with this critically important area, because erhaps he knows statins are extremely limited in their effectiveness in the vast majority of people who take them. Better, I suggest, to bang on and on about some other topic that maybe provides a convenient diversion.

I don’t know, but I have a sense that Professor Collins’ crusade to have the papers retracted was as much about censoring the truth about statin effectiveness as writing any wrong to do with adverse effects. And I am delighted to say he did not get away with it.

In fact, I suspect rather that Professor Collins’ ‘shock and awe’ tactics have spectacularly backfired. I think he has come across as bullying and aggressive (and wrong). But there is worse in store for him: The committee ad the editor of the BMJ have drawn our attention to the fact that the data held my Professor Collins and his colleagues at the CTT is for their eyes only. No-one else can have access to it nor is in a position to verify their conclusions about statins. In the interests of transparency and scientific integrity, they are calling for this data to be made public.

My personal opinion is that Professor Collins and some of his colleagues have done considerable damage to the reputation of medical and research fraternities. I’d say his actions will have contributed to the growing mistrust members of the public appear to have for ‘experts’. Being eminently credentialed does not guarantee that someone will always seem keen to uphold the basic tenets of good medicine and good research.

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