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Zetia Efficiency Trumped By Niacin

Posted by Jane Akre
Monday, November 16, 2009 11:20 AM EST
Category: Major Medical
Tags: Cholesterol, Niacin, Zetia, Vytorin, Merck, Heart Attack, Stroke, Risk Factors, Cardiovascular Health

Zetia was not as effective as niacin in reducing plaque in arteries.

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IMAGE SOURCE: ©iStockphoto/ cholesterol lowering drugs/ author: dlerick

Cheap B Vitamin- Niacin

Proponents of alternative and complementary health have been saying it for some time. There are more natural alternatives to expensive prescriptions drugs to curing the ills of growing older.

Now scientists have found one easy alternative seems to fit that bill.

Millions of people take Zetia, made by Merck, but in a newly published study in the New England Journal of Medicine (NEJM), researchers found that a cheap B vitamin, niacin, beat the pricy cholesterol drug in reducing plaque build-up in the arteries.

208 patients with coronary heart disease or a risk equivalent, who were on long-term statin drugs such as Crestor or Lipitor, were involved in the study.

Zetia, known generically as ezetimibe, also reduces LDL or bad cholesterol and is often prescribed when the others don’t work. It was thought to be highly effective at reducing LDL.

But the 14-month study had to be curtailed early after just one year when the patients taking the inexpensive niacin showed a significant reduction in the thickness of the plaque forming in the artery of the neck, which supplies blood to the brain, when compared to the Zetia group.

There were no changes in the Zetia group in plaque build-up.

Besides reducing plaque, niacin increased HDL or good cholesterol by 18.4 percent over the study period.

The Zetia group showed a reduction in LDL by almost 20 percent, but patients taking the drug had a slight worsening of the plaque build-up, reports ABC News.

And nine patients in the Zetia group had heart attacks or stroke or died from heart disease versus two patients taking niacin.

"This trial doesn't quite put the nail in the coffin for ezetimibe, but it pushes it way down on the list of medications for cholesterol-lowering therapy," said Dr. Anthony DeMaria, a leading cardiologist who is editor in chief of the Journal of the American College of Cardiology.

Bottom line - Niacin should be the add-on therapy to reduce plaque buildup on the arteries.

At a news conference, cardiologist, Dr. Allan Taylor with Walter Reed Army Medical Center added that at a time when the nation is pushing to reduce health care costs – it’s time to switch to niacin.

Even the branded formulation, called Niaspan, used in the trial, is significantly cheaper than Zetia. Dr. Taylor was questioned about taking more than $10,000 in lecture fees from the maker of Niaspan, Abbott.

Critics, one writing an editorial in the NEJM, said that the trial should not have been terminated early. Others believe that plaque accumulation in the artery wall is not as good an indicator as having another heart attack.

Early Saturday morning, Merck issued a press release - "Merck today confirms and underscores its commitment to marketing and developing cardiovascular medicines for a range of cardiovascular disorders."

Merck has already had problems defending Vytorin, after the editors of the New England Journal of Medicine (NEJM) last year advised patients use Vytorin with caution because of a cancer concern. Vytorin is a combination drug made up of Merck’s Zocor, a statin drug, and Schering-Plouugh’s Zetia, a newer cholesterol lowering drug.

The New York Times is reporting that some prominent cardiologist say the drug should not be sold.

In 2008, approximately 9 million Americans were on Zetia versus just 2.5 million taking niacin. #


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