Heart Drug 'Hype'? Docs Debate Crestor

On Nov. 9, when the results of a trial on the use of statin drugs became public at the American Heart Association meeting, they were so promising that some heart experts believed they had the power to change medical practice.

Many felt the study would hail a new era in the use of the cholesterol-lowering drugs -- one in which more people would take these drugs for elevated levels of a heart disease marker known as C-reactive protein (CRP), and not for elevated cholesterol alone.

Now, nearly a month later, some primary care physicians say that such a shift has not yet occurred -- and that the benefits of the drug known as Crestor do not come without costs.

"The hype about this study is very far from the mark, scientifically," says Dr. Lee Green, a professor of family medicine at the University of Michigan in Ann Arbor.

"Lifestyle modification works better, and doesn't carry the risks of the medication," agrees Dr. Linda Prine, associate clinical professor at New York City's Beth Israel Medical Center.

Green adds that he feels the trial was an attempt by AstraZeneca, the drug's manufacturer, to resurrect a compound that has done poorly on the market due to side effects.

"This study is the ultimate research-as-marketing-tool achievement," Green says.

In an e-mailed statement to ABC News, AstraZeneca maintained that Crestor's safety profile is in keeping with that of other statins -- and that it is now up to doctors and others to use the data from the JUPITER trial as they see fit.

"As is appropriate, the medical community, regulators, and guideline committees will now carefully consider these data and any implications for treating patients," the statement reads.

After the Enthusiasm

The initial results from the JUPITER study appeared encouraging. The study, which examined the effect of Crestor (the trade name for the statin drug rosuvastatin) on healthy middle-aged patients with normal levels of "bad" cholesterol but elevated CRP levels, showed that those taking the drug enjoyed a reduced risk of heart attack, stroke and death.

Cardiologists were perhaps the most enthusiastic over the results. In an online poll conducted by the website Cardiosource last month, most respondents said they would measure CRP in at least some of their patients. Some cardiologists already use CRP to help them decide whether to prescribe statins to patients who already have certain heart risk factors; for them, JUPITER was one more piece of evidence that CRP testing could save lives.

"CRP is like a barometer of all the different risk factors," says Cardiosource editor Dr. Christopher Cannon, associate professor of medicine at Harvard Medical School and senior investigator in the TIMI Study Group.

And while non-cardiologist doctors tended to be somewhat more divided on the issue, many still anticipated that the research would make waves in clinical practice. Following the release of the study, the New England Journal of Medicine Web site polled medical professionals on whether they felt doctors should change their practice because of the study.

Of the more than 2,500 responses were received, 49 percent said the findings should affect laboratory testing, and 48 percent said statin drugs should be used differently in the wake of the trial.

Still, the drug is not without its risks. Side effects of the drug, which can range from mild to severe, include muscle and liver problems, as well as an increased risk of diabetes.

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