Should Patients Continue Use Of Vytorin?
Patientshave begun "swamping" physician offices to ask whether they shouldend treatment with the cholesterol medication Vytorin, co-marketed by Merck and Schering-Plough, after a recent study found the treatment nomore effective than a treatment available in generic form in the prevention ofaccumulation of plaque on artery walls, the Wall Street Journalreports (Winslow, Wall Street Journal, 1/17).
For the study, led by John Kastelein of the University of Amsterdam Medical Center, 720 participants took either Vytorin -- acombination of Zetia, which blocks absorption of cholesterol in the intestines,and Zocor, a statin available in generic form -- or Zocor alone. The study,which lasted two years, found that participants who took Vytorin experienced a58% decrease in their LDL cholesterol levels, compared with 41% for those whotook Zocor. However, the study found no statistically significant difference inthe accumulation of plaque on artery walls among participants who took Vytorinand those who took Zocor (Kaiser Daily Health Policy Report, 1/15).
According to the Journal, the study offers "only limited newinformation to influence whether patients should take the drug" andprovides "no clear signals that patients should stop using Vytorin" (WallStreet Journal, 1/17).
The American College of Cardiology on Tuesday issued a statement topatients and physicians that recommended they not base treatment decisions onthe study alone (Wall Street Journal, 1/17). The statement saidthat "there's no reason for patients to panic," adding that patients"should never stop taking any prescription medication without firstdiscussing the issue with a health care professional" (Sternberg, USA Today, 1/17). ACC said that Vytorin and Zetia both remain "reasonable" options to help some patients reduce cholesterol levels and risk for heart attacks.
However, patients and many physicians "are caught in the controversy, uncertain what course to take," according to the Journal (Wall Street Journal, 1/17).
In related news, the New York Times on Thursday examined how, although the "theory that lowering cholesterol is always beneficial has been a core principle of cardiology" for decades, "now some prominent cardiologists say the results" of the study and other research have "raised serious questions about that theory" (Berenson, New York Times, 1/17).
Reprintedwith permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, and sign upfor email delivery at kaisernetwork.org/email . The Kaiser Daily Health PolicyReport is published for kaisernetwork.org, a free service of The Henry J.Kaiser Family Foundation.