there are very good reasons for sticking with the older drugs . here we have a problem, a possible problem , that only shows when large numbers of people are taking a drug chronically over a long time. the old drugs have already been thru that and , contrary to dana, they do work quite well.
remember vioxx
there is nothing like being a human test experiment.
Angiotensin Receptor Blockers (ARBs) have become one of our most popular hypertension drugs in recent years.
And now they’re facing a cancer scare.
A new study in the British journal Lancet Oncology conducted by Case Western in Cleveland shows a small but “statistically significant” rise in cancer cases, 1.2%, among patients taking ARBs.
Istanbul-native Ilke Sipahi (right) led the team that looked at all the past studies on ARBs they could find and came up with the number.
(The folks at We Are the Turks, from which the picture was taken, are very proud of Dr. Sipahi. With good reason.)
Some reporters are panicking over this result, but a Cleveland Plain Dealer piece on the study offers more facts.
The only ARB for which any link could be statistically established was telmisartan (Micardis), the only link that could be shown was to lung cancer, and even there they couldn’t isolate other risk factors like smoking. This was due to the limits of the data.
The only real conclusion here, offered by Dr. Sipahi, is this possibility deserves further study. He notes that Angiotensin Converting Enzyme (ACE) inhibitors are a pretty safe alternative if you do have concerns, and hopes the FDA and drug companies will cooperate over the several years needed for this work.
Full disclosure. I’ve been on ARBs for years. I first took Diovan, aka valsartan, and now take it along with a calcium channel blocker, a pill called Exforge. I had previously found ACE inhibitors did not do the job, and that diuretics put me to sleep.
I’m not panicking, and neither should you. But there is an important point to be made here. Studies like this look at clinical trials, where one variable is being isolated, and are conducted by screening all the data through a second variable.
We’re not talking about population studies. As Electronic Health Records (EHRs) become more common, we will have the capability of doing much larger studies, with millions of records, that could quickly isolate risk factors and separate real risk from noise.
Stripping personal information from EHR data, making EHR databases compatible, and analyzing these millions of records coherently is going to move to the center of medical research over the next few years, and if one of those studies shows that ARBs cause cancer, or anything else, then I might worry.
But I’m not going to blame the carpenter for his tools. Dr. Sipahi did great work here with what he had. I just wish he had more to work with.
