What is a Cholesterol Patient to Think?

by Mark S. Senak
Eye On FDA



I have very high cholesterol. I don't even want to tell you how high. But I am also a bit of a statin-phobe. So when my doctor prescribed Vytorin, despite the extremely attractive direct-to-consumer advertising, I resisted. Vytorin is a combination of Zetia and Zocor, two anti-cholesterol agents that act in different ways to affect cholesterol levels. You've seen the commercials with food and people who look alike because both food and heredity play a factor in your cholesterol levels. Despite all that, the Vytorin sat on my shelf, unused, much to the frustration of my physician.

Then last week there were published studies that indicated that lower cholesterol levels might mean a lower risk for cancer. I began to re-think my resistance. Maybe I should start taking the Vytorin as part of my annual New Year's effort to feel healthier as I age.

But now, this week, a study called ENHANCE has been released whereby it is shown that one of the drugs, Zetia, involved in the combination therapy Vytorin, while lowering cholesterol, does not lessen plaque and therefore is not effective in lowering heart attack risk. Dr. Steven Nissen, head of cardiology at the Cleveland Clinic state in a Forbes article that physicians should only prescribe Vytorin as a last resort. Forbes also reports that the study results were available last year, but that there was a delay in their release, which will also result in another Congressional investigation.

None of this is good for the image of the industry, it goes without saying. But for those of us with a bottle of Vytorin sitting on our medicine shelf, it raises further question about decisions when and how to take pharmaceutical products. When do we supplant our physician's opinion and advice with our own?

The companies involved have a lot of work to do, and interestingly, as of today, there is no information that I found on the Vytorin Web site to talk about the ENHANCE issue nor could I find anything on the Web site for Zetia. Is lower cholesterol better, or is it better to lower your plaque?

There is more at stake here than one drug. For society at large, it is about how we get and perceive the information we are getting about treatments and how we react to it in the course of our own treatments that is most important. And for me - I can only say that I, for one, wonder what is a patient to think? And I feel very left on my own to figure it out.





Eye On FDA is a regular contributor to BioHealth Investor
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