Cardiology experts meeting in Chicago this week reaffirmed statins as the best way to treat cholesterol and heart disease, the biggest cause of death in industrialized countries. The star status of the drugs, which have become the standard way to cut cholesterol levels for people with heart worries since they appeared 15 years ago, was reinforced by the recent failure of a drug tipped to be the next big thing. The full results of a clinical trial presented to the American College of Cardiology (ACC) annual conference here Sunday confirmed that the new drug, Vytorin, fails to reduce cholesterol build-up in arteries. And a group of top American cardiologists picked by the ACC presidency have now publicly called for the focus to be shifted back to statins as the best way to cut cholesterol and reduce deaths from heart disease. Statins are present in all the top anti-cholesterol drugs, including Crestor, from Britain's AstraZeneca, Zocor from America's Merck, and Lipitor from Pfizer. They represent a global market worth 35 billion dollars a year. Vytorin, from the Merck and Schering-Plough laboratories, first went on sale in 2004 and has been prescribed to millions of Americans. It costs four times as much as other generic cholesterol-busting drugs, including statins.But in a clinical trial review presented to the conference, lead author John Kastelein of the Academic Medical Center in Amsterdam said Vytorin had produced no results. He admitted later he had been very surprised by the outcome. The drug has also been discredited by the 18-month delay between the end of the clinical trial in 2006 and the announcement of the full conclusions in January 2008, prompting suspicions of fraud on the part of the manufacturers. Two US congressional committees have opened an investigation into the case. Many doctors had welcomed Vytorin, which combines Merck's Zocor (simvastatin) with Schering-Plough's Zetia (ezetimibe), sold since 2002 to cut cholesterol in the intestinal tract but not in the liver like statins do. Before the trial, Vytorin was seen as a major competitor to Crestor. But while Vytorin reduced cholesterol levels, it failed to reverse arteriosclerosis, the hardening of the arteries that Crestor has shown a proven ability to affect. Crestor's star status increased when AstraZeneca announced Sunday it would be prematurely ending a large study on the drug as a preventative treatment for heart problems because it had yielded such positive results. The same day, a clinical trial review presented to the ACC conference confirmed Crestor reduced the build-up of atheroma plaques that block the arteries, proving once again that the drug can help treat heart disease. Statins – sometimes referred to as the aspirin of the 21st century – have also shown they can play a role in fighting certain cancers, Alzheimer's disease and inflammatory rheumatism, with varying results. And a recent American study published in the European Journal of Respirology found statins cut the number of deaths caused by pulmonary infections by almost half. __
