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Cholesterol Drug Shows No Benefit, Possible Harm

Zetia (ezetimibe) doesn't slow the progression of arterial plaque but rather may increase plaque growth, according to results from the Enhance study. Merck/Schering-Plough Pharmaceuticals says it has submitted an abstract about the trial for presentation at the American College of Cardiology in March.

The trial, performed in 720 patients with familial hypercholesterolemia, found that the mean carotid intima-media thickness increased by 0.0111 mm among patients on a combination of Zetia and Zocor (marketed as Vytorin) compared with 0.0058 mm among those on Zocor alone — a statistically nonsignificant difference, the manufacturer reports.

The New York Times emphasizes that the plaque growth rate among patients on Zetia was nearly doubled. Accordingly, the paper quotes Dr. Stephen Nissen from the Cleveland Clinic as saying that Zetia should be used only as a last resort.

Currently in the U.S., about 20% of all prescriptions for cholesterol-lowering medicines are for Zetia or Vytorin, according to the Times.

LINK(S):

Manufacturer press release (Free)

New York Times story (One-time registration required)

Zetia label (Free PDF)

Published in Physician's First Watch January 15, 2008