Another week, another set of studies calling into question the benefits and risks of a widely used drug. This time it's Vytorin, a cholesterol-lowering drug that combines a statin (in this case Zocor) with a drug that lowers bad cholesterol a different way (Zetia, aka ezetimibe).
As usual, the story is getting political (Congressional hearings to determine whether negative data was withheld) and financial (shares in drugmakers Merck and Schering-Plough tanked with the news).
But let's strip away the drama and plank out Three Things You Need to Know:
1. The new data shows Vytorin is not just ineffective at preventing plaque buildup in the arteries, but it's linked to faster growth of the gunk. Which is to say, a drug prescribed to reduce atherosclerosis appears to speed its progression.
2. Having said that, Vytorin is more effective than statins alone in lowering bad (LDL) cholesterol, as well as C-Reactive protein (CRP), a marker of inflammation that may be linked to heart disease. But these benefits didn't translate into clearer arteries.
3. The American College of Cardiology has released an explicit statement in response to the Vytorin data, saying statins alone, at the maximum tolerated dose, should be the first line of defense against coronary artery disease. Prominent cardiologist Steven Nissen of the Cleveland Clinic was more blunt: Vytorin should be a drug of "last resort."
So: If you're taking Vytorin (or Zetia)--stop us if you've heard this before--consult with your physician. But don't quit taking the drug until you've done so.
Here's the New England Journal of Medicine article on Vytorin at the center of the controversy.
And of course here at CholesterolNetwork you can ask a question of any of our heart disease experts, including cardiologists and other clinicians.
Published On: April 01, 2008