I wish I had more confidence that they’re not just treating a symptom:
As for the efficacy of the drugs, it is not yet proved that very low LDL levels produced by drugs lead to sharp reductions in heart attacks, strokes and deaths from cardiovascular disease, as researchers have seen in people with the naturally inactive PCSK9 gene.
Many cardiologists, though, are persuaded by a large body of evidence supporting the idea that the lower the LDL, the lower the risk.
“I believe lower is better and do not believe that a very low LDL is harmful,” said Dr. Daniel Rader, a cardiologist at the University of Pennsylvania.
Others, like Dr. Harlan Krumholz, a cardiologist at Yale, urge caution. “We are in a period of exuberant enthusiasm about these drugs,” he said. “We could just be performing cosmetic surgery on a lab value.”
If it were certain that the PCSK9 inhibitors were safe and effective in preventing heart attacks and deaths there would be no need for clinical trials, he noted.
$14,000/year is a lot of money for a treatment for which we have no idea whether or not it’s effective. I think improving diets would be much more cost effective.
[Update Tuesday morning]
Here’s a longer piece about the new drugs and the issues. Note: 1) It is assumed that the goal is to lower cholesterol, and that this will in turn result in lower mortality and 2) No mention of diet as a potential solution. Of course, it’s hard to get people to change their diets. But I suspect that to the degree that doctors are telling people to do so, they’re still telling them to cut out sat fat and cholesterol, despite all the actual science, and probably still telling them to follow FDA food-pyramic advice, which is junk science.