Cholesterol is bad for you
That doesn’t sound like a very interesting headline, but an important clinical trial whose results were released today has made definite steps towards re-convincing researchers on this point.
The trial, IMPROVE-IT, looked at adding a new drug, ezetimibe, to one of the standard statin drugs for cholesterol lowering, in people who had previously had a heart attack. Ezetimibe works by blocking cholesterol absorption in the gut, a completely different mechanism to the statins, which block cholesterol synthesis. The drug had previously shown unconvincing results in a preliminary study, made even less convincing by the behaviour of the manufacturer. There was increasing uncertainty that the cholesterol-lowering effect of the statins was really how they prevented heart disease, since no other drug appeared to be able to do the same thing.
Now, IMPROVE-IT has found a reduction in heart attacks and strokes. It’s very small — only 2 percentage points, even in this high-risk group of patients — but it looks real. Given the price of ezetimibe it probably won’t be widely used immediately, but it comes off patent in a few years and then use might spread a bit. The results are also encouraging for dietary approaches to lowering cholesterol by reducing absorption: some cereals, and spreads with plant sterols.
Other stories: Forbes, New York Times






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