Study Prompts Patients To Question Whether They Should Continue Use Of Vytorin

Patients have begun "swamping" physician offices to ask whether they should end treatment with the cholesterol medication Vytorin, co-marketed by Merck and Schering-Plough, after a recent study found the treatment no more effective than a treatment available in generic form in the prevention of accumulation of plaque on artery walls, the Wall Street Journal reports (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 -- a combination 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 a 58% decrease in their LDL cholesterol levels, compared with 41% for those who took Zocor. However, the study found no statistically significant difference in the accumulation of plaque on artery walls among participants who took Vytorin and those who took Zocor (Kaiser Daily Health Policy Report, 1/15).

According to the Journal, the study offers "only limited new information to influence whether patients should take the drug" and provides "no clear signals that patients should stop using Vytorin" (Wall Street Journal, 1/17).

The American College of Cardiology on Tuesday issued a statement to patients and physicians that recommended they not base treatment decisions on the study alone (Wall Street Journal, 1/17). The statement said that "there's no reason for patients to panic," adding that patients "should never stop taking any prescription medication without first discussing 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).