Merck's Cholesterol Drug Slashes Heart Risks in Healthy People
Bloomberg News May 26, 1998, 1:01 p.m. PT
Merck's Cholesterol Drug Slashes Heart Risks in Healthy People
Chicago, May 26 (Bloomberg) -- Merck & Co.'s cholesterol- lowering drug Mevacor reduces the risk of first heart attacks even for those who don't have high cholesterol, suggesting that more people should be getting the drug, a newly published study shows.
An additional 6 million Americans could benefit -- in the form of preventing heart disease and major cardiac problems -- from expanding the federal government's treatment guidelines to include patients with normal total cholesterol levels and lower- than-average ''good cholesterol'' levels, the researchers said.
The study of 6,605 men and women with no signs or symptoms of heart disease, treated with Mevacor or placebo then monitored for more than five years, was first presented in November. The Merck-sponsored clinical trial is published in tomorrow's Journal of the American Medical Association.
Research previously showed that Mevacor and similar drugs, which generate billions of dollars in annual sales, reduce heart risks for those with high cholesterol levels. This is the first study that shows the drugs reduce risks in patients not normally considered candidates for drug therapy.
Patients taking Mevacor had a 37 percent lower risk of a heart attack, severe chest pain, or death than those on placebo, and the drug didn't cause any serious side effects, the study found. Mevacor also reduced total and low-density lipoprotein, or ''bad'' cholesterol levels by 18 percent to 25 percent.
A review article in the journal by Drs. Robert S. Rosenson and Christine C. Tangney concluded that Mevacor and similar drugs known as statins may have beneficial effects on inflammation, plaque, which builds up in arteries to cause heart disease, and blood clots, which can trigger heart attacks, in addition to cholesterol.
The study's findings changes the question about who should get Mevacor and similar drugs made by Bristol-Myers Squibb Co., Novartis AG, Pfizer Inc. and Warner-Lambert Co., said Dr. Thomas A. Pearson from the University of Rochester School of Medicine in an editorial. Instead of asking who should get the drugs, doctors and researchers need to identify the patients for whom the costs outweigh the benefits, he said.
Currently, the drugs cost between $900 and $1,800 annually per patient. If Mevacor was given to 1,000 people for five years, it would prevent 12 heart attacks, seven cases of severe chest pain and 17 procedures to restore blood flow to the heart, the researchers said.
While the benefits are significant, they might not be cost- effective in such a low-risk group of patients, Pearson said. Instead, the guidelines for cholesterol-lowering drugs should be reviewed to determine if other groups of patients -- such as those with high blood pressure, who have a family history of heart disease or smoke -- should be included.
''Such a data-driven approach will be useful to establish new benchmarks for preventive medicine and to help the clinician answer the increasingly difficult question of whom not to treat,'' Pearson said.
--Michelle Fay Cortez in Ithaca, New York (607) 272-1174, through |