Cholesterol Drug Zetia Doesn't Cut Heart Attack Risk: Study

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"These results are very important considerations on how we treat patients with elevated cholesterol and will very likely impact the way we choose drugs to lower cholesterol and eliminate plaque," said Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardio-Vascular Disease at New York University Medical Center, New York City, and clinical associate professor at the NYU School of Medicine.

"ENHANCE found that plaque got slightly worse when the drug combination was used," Weintraub noted in a statement. "But, the real take-home message here is that getting LDL down is important, and that's not something that should be lost as a consequence of this study."

The ENHANCE study was completed in April 2006, but the results were only released Monday by Merck and Schering-Plough after continual prodding by medical professionals. According to The New York Times, the companies had initially planned to release the findings by March 2007, but then missed several self-imposed deadlines, blaming the delay on the complexities of necessary data analysis.

Now that the results have arrived, Zetia and Vytorin should be viewed as "drugs of last resort," for patients not helped by standard statin therapy, Nissen said. Only if you can't tolerate full doses of simvastatin should you take ezetimibe, he said.

"This is one of the most widely advertised and widely used drugs out there, so it's obviously good to get these study results," Nissen added.

Another group questioned why patients should be prescribed more expensive cholesterol-lowering drugs, such as Vytorin, versus cheaper, generic statins such as Zocor.

"We already know that millions of people who take these brand drugs probably don't need to; they could be taking a less expensive generic instead. This study lends support to that cost-saving strategy for the health system and for consumers," said Steven Findlay, managing editor of Consumer Reports Best Buy Drugs, a public information and education project of Consumers Union, publisher of Consumer Reports.