Area doctor tells patients to stay on Vytorin
Study said cholesterol drug doesn't perform
BY MICHELLE L. START Florida Weekly Correspondent

When two drug companies announced this week that their drug Vytorin had not produced the desired results in a case study, it made national news and alarmed a local cardiologist who is worried that patients will stop taking the medication.

"We are a little concerned about trying to get a clear message out to patients," said Dr. Richard Chazel. "There is no need to be upset or to stop their medication."

The findings of the ENHANCE trial showed that while Vytorin did reduce in low-density lipoprotein cholesterol, it did not make any difference in the progression in plaque, heart attacks or deaths. The study involved 720 patients.

Vytorin has been heavily marketed. Chances are you have seen the ads. "There are two sources of cholesterol: food and family. Vytorin treats both."

It works inside of the digestive tract and runs about $100 for a 30 day supply. Merck/Schering-Plough Pharmaceuticals market the drug. Vytorin is a combination of Zetia and Zocor. Zocor, which is available in the generic format, is a statin that lowers cholesterol. The promise with Zetia was that it would help block the absorption of cholesterol that comes from food.

"Zetia is not a first line of defense drug," said Chazel. "The jury is still out on Zetia. This first report did not indicate that it added any benefit."

He said that while doctors have long thought statins worked because they reduced cholesterol, they may actually work instead on lowering the risk of heart attack and stroke because of what they do within the blood vessels.

"We can't effectively measure blood vessel walls yet," he said.

Still, Chazel cautions patients against stopping Vytorin. Instead, he said they ought to talk to their doctor.

"I think there are a couple of lessons in this," he said. "In our world, 700 patients or so is a relatively small trial. There are two to three large trials yet to be reported. We are working off relatively limited data. No harm has been done by this medication. This is not a matter of increased risk."

The drug companies have three other trials in progress that involve more than 20,000 high-risk patients.

Additionally, Chazel said that the trial results have not yet been formally presented and that there may be more information coming out when that happens in March. Chazel, who is a trustee for the American College of Cardiology, intends to be at that presentation.