New Cholesterol-Lowering Drug

Oct. 29 -- A drug just approved by the Food and Drug Administration offers a new strategy for the estimated 20 million Americans taking cholesterol-lowering drugs.

Zetia, made by Merck/Schering-Plough Pharmaceuticals, received approval late last week to treat cholesterol via a different mechanism than that of cholesterol drugs already on the market. Unlike the widely prescribed statin drugs, which block cholesterol production, Zetia works by preventing the absorption of cholesterol in the intestine.

Because the mechanisms of action are different, Zetia may be used in concert with statin drugs in an effort to drop cholesterol levels still further.

This may be especially important for a number of people taking statin drugs who have not managed to reach their target cholesterol levels.

"Although statins are first-line because we have very good safety and efficacy data, if you take a look in clinical practice, probably only about 40 percent of these high-risk patients are at their target," says Dr. Christie Ballantyne, director of the center for cardiovascular disease prevention at Baylor College of Medicine in Houston, who has conducted research on Zetia.

Risks and Benefits

According to NDS Health, a health-care information services company based in Atlanta, more than 110 million prescriptions were written for statin drugs in 2001.

While favored for their efficacy, these drugs do not come without risk. Possible side effects include muscle and liver damage. Even though the incidence of these side effects is rare, one statin drug, Baycol, was withdrawn from the market after reports of severe and sometimes fatal muscle reactions.

The loss of Baycol has made many physicians more attentive to the possibility of side effects and their patient's concern about safety.

"I have definitely had to increase my discussion of side effects of statin-type cholesterol medications with my patients," says Dr. Scott Smith, a family physician from Kaiser Permanente in Denver. "Many more people are concerned about them."