Ezetimibe In the Marketplace

Several years ago, the Schering-Plough cholesterol absorption inhibitor (Zetia, ezetimibe) and its combination pill with simvastatin (Vytorin) were the subject of a lot of puzzled controversy. A clinical trial (ENHANCE) looking at arterial wall thickness in patients with familial hypercholesteremia had unexpectedly shown little or no benefit, although statins themselves had worked in this population. This led to plenty of (still unresolved) speculation about the drug's mechanism of action, whether it really was going to be of benefit to the wider patient population, what this meant for the surrogate endpoint of LDL lowering (which the drug does accomplish), and so on. Sales of both Zetia and Vytorin took a hit, naturally. But a new editorial in JAMA wonders why they're selling at all, and particularly, why they're doing so well in Canada. A new paper in the American Heart Journal shows that ezetimibe sales in the US went down 47% over the next year after the ENHANCE results came out. But in Canada, it just kept rolling along. (Even after the decline, though, it's still used more in the US). What's causing this? Quite likely, an over-focus on cholesterol levels themselves: Krumholz, one of the coauthors on the study with Jackevicius, remains perplexed as to the continuing popularity of ezetimibe. “The drug continues to defy gravity, and that’s probably a result of really strong marketing and the singular focus on cholesterol numbers,” he said. Krumholz said heart hea...
Source: In the Pipeline - Category: Chemists Tags: Cardiovascular Disease Source Type: blogs