There was a two-page ad in this morning’s Seattle Times for Vytorin® (ezetimibe/simvastatin), which is a combination of two older drugs (Zocor and Zetia) for lowering cholesterol. The headline said, “Do you have high LDL cholesterol? It’s important to talk to your doctor about ways to lower it.” After a few sentences about how the drug works to lower cholesterol, it says in bold type, “Vytorin has not been shown to reduce heart attacks or strokes more than Zocor alone.” I did a double take when I read that. Why would a company place a very expensive ad to tell you the product they are pushing doesn’t work? The second page lists the devastating side effects of the drug, but it fails to mention that Merck’s own trails showed MORE heart attacks and an INCREASE in the thickness of artery plaque in people taking the combined drug, even though it was 20% more effective at lowering cholesterol than Zocor alone. (The control group taking Zocor also showed an increase in plaque.)
The results of the study, called Enhance, which was completed in April of 2006, were not released until January of 2008. It made headlines in the New York Times; “A clinical trial of a widely used cholesterol drug has raised questions both about the medicine’s effectiveness and about the behavior of the pharmaceutical companies that conducted the study,” said the article by Alex Berenson. He goes on to quote Dr. Steven E. Nissen, the chairman of cardiology at the Cleveland Clinic, who said the results were “shocking…This is as bad a result for the drug as anybody could have feared, Millions of patients may be taking a drug that does not benefit them, raising their risk of heart attacks and exposing them to potential side effects.”
http://www.nytimes.com/2008/01/15/business/15drug.html?pagewanted=2&_r=1&sq=vytorin&scp=1.
To read what Dr. Eades had to say about the study go to: http://www.proteinpower.com/drmike/statins/vytorin-dis-enhance-d/. Dr. Briffa’s take is here: http://www.drbriffa.com/blog/2008/03/31/some-doctors-suggest-that-lower-cholesterol-levels-may-not-be-better-after-all/
So why does a company spend huge amounts of money to advertise a drug that not only doesn’t have any benefit, but actually makes the targeted problem worse? Just the fact that the ad is there gives the impression that this is a useful medication and may lead many people to pressure their doctors to prescribe it. Cholesterol is so firmly established in the minds of most of the population as the world’s most dangerous substance that lowering it may be seen as a good thing in and of itself. Perhaps Merck hopes to cut their losses on this failed drug by continuing to have doctors put patients on it, in spite of the consequences. Another possibility is that they may be trying to head off future law suits since now they can point out that they told us, in bold print no less, that Vytorin does not reduce heart attacks or strokes. If doctors choose to prescribe it anyway, then it will be their insurance that is liable.
