Do PCSK9 inhibitors prolong life?

In light of the recent decision by the UK health authorities to approve inclisiran for use in patients, I thought it would be interesting to delve in to how good the class of drugs it belongs to, the PCSK9 inhibitors, really are. PCSK9 inhibitors can be thought of as “next generations statins”. Like statins, they work under the assumption that the lipid transport molecule LDL … Read more

Do drug trials underestimate side effects?

One commonly used trick in drug trials is to exclude any group that might make the drug look worse, such as those that are more likely to experience side effects. A good recent example of this is the covid vaccine trials, which largely excluded people with auto-immune diseases (more likely to develop an auto-immune disease after vaccination), people with allergies (more likely to have an … Read more

Vaccines: truth, lies, and controversy

Peter Gotzsche is no crank. Rather the opposite, in fact. In the world of evidence based medicine, he is one of the great heavyweights. He was a founding member of the Cochrane collaboration, is a professor of clinical research methodology at the university of Copenhagen, and has had his work repeatedly published in all the leading medical journals. His blunt honesty and willingness to speak … Read more

Update on ivermectin for covid-19

Back in January I wrote an article about four randomized controlled trials of ivermectin as a treatment for covid-19 that had at that time released their results to the public. Each of those four trials had promising results, but each was also too small individually to show any meaningful impact on the hard outcomes we really care about, like death. When I meta-analyzed them together … Read more

Do anti-depressants work?

Anti-depressant drugs are common. Very very common. According to the Centers for Disease Control in the United States, 13% of adults reported taking an anti-depressant when surveyed a few years ago. Among women over the age of 60, almost one in four was taking an anti-depressant!

When I work in the hospital, I frequently see elderly people who are on five, ten, fifteen, or … Read more

How much oxygen is enough?

Only a few years ago, back when I was in medical school, I was taught that the goal of oxygen therapy should be to push saturation above 95%, and that anyone who comes in to hospital with a saturation below that should receive oxygen therapy (with the exception of people with chronic obstructive pulmonary disease, whose bodies have adjusted to lower oxygen levels). For those … Read more