A clinical trial of Zetia, a popularly prescribed cholesterol-lowering drug, “failed to show that the drug has any medical benefits.” In fact, fatty plaques grew almost twice as fast in patients who took Zetia along with Zocor in a combo product called Vytorin. However, “patients who are taking Vytorin or Zetia should talk to their doctors if they are concerned and not discontinue taking the medicines on their own.” [New York Times]

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  1. Dead Wrestlers Society says:

    My mom called me last night and was very upset about this. She’s been taking Zetia for about a year. Apparently, Merck Medco has known for a couple of years it doesn’t lower cholesterol. There is a special place in hell for some of these drug company muckety mucks.

  2. nrwfos says:

    Okay, I’m hit again. Now 2 drugs I take (and they aren’t cheap) are not only ineffective, but maybe harmful to the condition the drugs are used for. My insurance company and bank will be very happy when I am able to discontinue these.

  3. Jaysyn was banned for: http://consumerist.com/5032912/the-subprime-meltdown-will-be-nothing-compared-to-the-prime-meltdown#c7042646 says:

    Whiskey Tango Foxtrot?

  4. homerjay says:

    @public enemy #1: I smell a class action!

  5. The Great Aussie Evil says:

    I smell a placebo♪

  6. jaydez says:

    Get a lawyer, class action lawsuit… try to get at least some money back.

  7. GiselleBeardchen says:

    My cholesterol levels were out of control for several years. My doc tried every drug available on me but they where all either mostly ineffective or produced unlivable side effects. About three years ago we happened upon the combination of Crestor and Zetia (had been taking Crestor alone for about a year with very limited success)and in 6 months my levels were all good and are all now very low.

    The increased plaque thing scares the crap out of me though!

  8. Jetfire says:

    “The Enhance trial covered patients with a gene that causes them to produce very high levels of low-density lipoprotein cholesterol, commonly called L.D.L., or bad cholesterol.”

    “[P]atients who took Vytorin reduced their cholesterol by 58 percent. Yet despite the larger cholesterol reduction, patients taking Vytorin actually had more growth in fatty plaques in their carotid arteries than those on Zocor.”

    So does this only affect some people?

    Or is everyone who takes the drug neck filling up with fatty plaque?

  9. theblackdog says:

    And they’re starting to put people on cholesterol drugs at younger ages (late 20s), I wonder how many people around my age could be screwed by this.

  10. mattpr says:

    Zetia and Vytorin are designed to lower cholesterol, not cure artheresclerosis. Although statins are the most common treatment, it is not a guarantee that they will reduce fatty deposits, as there are a number of pathologies that can cause it independent of cholesterol production. You can’t really blame the drug companies for this one.

  11. Bryan Price says:

    I’ve been on Zocor. My last test was 148. The trouble is, my liver enzymes go up when I take it, and my liver specialist hasn’t figured that out yet. He wants to do a biopsy. I did one 8 years ago, I don’t think I need one now. I probably just need to stay off the Zocor.

  12. homerjay says:

    Hey, at least it didn’t turn out to be Viagra instead.

  13. BG says:

    Mattpr has it correct. I talked to my doctor today (I’m on Zetia/Niaspan combo, as I can’t do statins), and while Zetia does lower cholesterol, it doesn’t do anything beneficial (beyond reducing the cholesterol numbers, which alone is not a huge benefit) to lower the risk of heart disease.

    Bryan, I’m in the same boat about liver enzymes as you are. The biopsy is unpleasant as a motherfucker, but if they’re telling you to get it done, get it done.

  14. gingerCE says:

    OMG! My parents are on Vytorin–one of them recently had bypass surgery. I’m gonna tell them to talk with their doctors asap.

  15. gingerCE says:

    My sis’s liver enzymes went way up when she was on Zocor. Her dr. asked her to stop it to see if it was the cause–the problem was her cholesterol shot up so her dr. told her to go back on Zocor. Hmmm–she was also on Lipitor previous. Is there any cholesterol lowering drug that doesn’t affect the liver?

  16. mattpr says:

    @gingerCE:

    Zetia does not act on the liver, but rather on the small intestine. It’s designed for people whose livers can’t tolerate traditional statins.

  17. tspack says:

    Okay, now I’m really glad I told my doctor no a few months ago when she wanted to put me on Vytorin because my cholesterol was 203.

  18. lenagainster says:

    Zetia, in combination with Welcol and Tricor, worked for me in getting my cholesterol numbers to an acceptable level, but my doc suggested I give a statin another try. I had felt that the statins causes some muscle weakness (or was it age-related?). With this news, I’m determined to go back to a statin.

  19. LilKoko says:

    How are these any better than the mystery-ingredients-super-herbal pills sold by “supplement” companies? They have the same chance of killing you but are at least cheaper?

  20. aaydemi says:

    Before everyone goes off and yells at their doctors for putting them on Vytorin, please read the article, or better yet, read the study. Somewhere down at the very end mentioned only in passing is one key facet that puts the credibility of this study in question:

    “The Enhance trial covered patients with a GENE that causes them to produce very high levels of low-density lipoprotein cholesterol, commonly called L.D.L., or bad cholesterol.”

    These people have a type of high cholesterol called “Familial Hypercholesterolemia.” For some reason, this very specific, small group of people who don’t represent the majority were selected. The people enrolled in this study had problems with atherosclerosis and fatty plaque formation because they have a variant of the gene that overproduces their body’s natural cholesterol. This is not the problem most of America has. Most of America consumes too much cholesterol, which Zetia blocks the absorption of.

  21. MickeyMoo says:

    @aaydemi:
    But don’t the Vitorin ads claim that it treats genetically caused cholesterol as well as dietary? (Lemon Pie and your aunt Betty – or however the ads go) so perhaps those are precisely the people that the “Familial Hypercholesterolemia” study targeted?

  22. mattpr says:

    @MickeyMoo:

    FH enhances serum cholesterol by preventing its clearing. It doesn’t matter the source of the cholesterol.

  23. fofy21 says:

    Step one: Calm down.

    Step two: Talk to your doctor before stopping Vytorin or Zetia.

    Let me start of by saying that I am not a fan of Vytorin, and haven’t prescribed it that often. That being said, there are a lot of problems with this study.

    Lots of trials have been done (including this trial) that show that Vytorin (which is a combo drug of Zocor and Zetia) lowers cholesterol more than just Zocor alone.

    What hasn’t been clear is whether that extra reduction in cholesterol (particularly LDL, the “bad” type of cholesterol) translates into less heart attacks or deaths.

    This is the first study to try to look at that question. That being said, what the researchers did was look at what is called a surrogate end point. Rather than looking at the difference in rate of heart attacks or death, which would take thousands of patients and several years (and it is important to note that such a trial is ongoing right now, and will be completed around 2010), the researchers looked at carotid intimal thickness, which is just a fancy way of saying the amount of buildup in the inner wall of the neck artery. Several prior trials have shown a link between worsened carotid intimal thickness and increased risk of death and heart attack. That being said, we are essentially looking at one thing and assuming it will lead to another.

    This trial showed that patients on Vytorin (Zocor and Zetia) achieved a lower LDL (bad cholesterol) compared to the patients on just Zocor. But, there was NO difference in change in carotid intimal thickness between the two groups of patients. While the absolute numbers were different (with the Vytorin group having the higher number), it was not statistically significant. This means the difference could be explained by chance alone. The other thing to keep in mind is that in this group of patients (and really all patients with high cholesterol), this thickness or plaque is growing…. this is the whole reason doctors put people on medicine. The thickness would have been a butt load worse in someone who hadn’t taken Zetia at all.

    The other important thing is that there was no difference in the two groups in terms of liver problems, deaths, heart attacks, or strokes.

    What I (and what I would recommend others) take out of this is that 1) Zetia is still safe, 2) Zetia reduces cholesterol better than Zocor alone, 3) That reduction in cholesterol unfortunately may not translate into what we really care about, which is less deaths and less heart attacks and strokes.

    To summarize: Don’t freak out. Zetia isn’t dangerous… it just may not be as good as some thought it was. Talk to your doc to see if you should be changed to something else (this is another huge can of worms, and I wont go into it here).

  24. zandblou says:

    The Zetia rep was in the local Walgreens this morning desparately spewing all kinds of crap, to the pharmacist, about how everything thing was a sham and their product was totally safe. The rep knows that this is against Walgreens policy, but apparently they are very scared even after sitting on these terrible results for so long.

  25. swalve says:

    Thank you doctors for clarifying. Seems like a huge fact to not report that this study was on a specific set of people.

    (I’ll ignore that we don’t even know that cholesterol causes problems, only that high cholesterol correlates with problems. More than likely, it is the lifestyle that causes high cholesterol also causes vascular disease.)

    It’s amazing how people pick and choose their facts.