The controversy about Vytorin and Zetia continues.
As I’ve been saying since this story began to break, the group of patients studied was one that had a genetic disease leading to very high levels of cholesterol.
This study was not done on normal patients.
Further, in this type of patient, it is not unusual to need three drugs to control their cholesterol levels. So, the fact that two drugs (Vytorin [ezetimibe & simvastatin] and Zetia [ezetimibe]), did not work to reduce plaque in the neck arteries should not be terribly surprising.
The real question is whether a drug like Vytorin, which dramatically lowers LDL(“bad” or “lethal” cholesterol), can reduce the risk of heart attacks or strokes. Studies looking at that are now in progress.
And, my guess is that they will show that Vytorin will be shown effective at reducing heart attacks, strokes, and deaths. Thus, I will continue to take it personally, as it has, along with diet and exercise, helped normalize my TC, HDL, LDL, TG, and ApoB (see the next blog entry).
But, in the meantime, I agree with those who say that physicians should use ezetimibe mostly in (1) those people in whom it is needed to get them down to a target level of LDL cholesterol (like me) or (2) those people who cannot tolerate high dose of statins.
Look for a study later this week showing that one statin, Crestor, actually reduces the plaque in coronary arteries to some degree.