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I Won't Dance. Don't Ask Me.

I Won’t Dance. Don’t Ask Me.

No doubt you’ve heard the recent controversy with Zetia – the drug that’s been proven to significantly lower cholesterol. The results of a new study confirm that after more than five years since getting FDA approval, there is zero evidence that the drug reduces artery plaque or prevents heart attacks – an equation that just does not compute in the cholesterol-crazy medical mainstream.

But wait – it gets better.

Vytorin is a drug that combines Zetia with the cholesterol-lowering statin drug Zocor. Wow! Now that’s GOT to reduce plaque and lower heart attack risk, right?

Mmmm not so much.

Here’s how the New York Times reported the results of a new study: “Instead, the plaques actually grew almost twice as fast in patients taking Zetia along with Zocor than in those taking Zocor alone.”

Now here’s the question: Do you enjoy watching people dance? Because the medical mainstream heavyweights who swear by statin use danced all around this one, and their “logic” is nothing less than hilarious.

Enhancing profits

We’re going to miss those cute Vytorin TV ads. You know the ones. On the left side of the screen we see a plate of food, and on the right side of the screen we see a person who wears something that resembles the food on the left.

The idea is that you don’t just get cholesterol from food, you also get it from your family. That is, you may have a genetic disposition to absorb greater amounts of dietary cholesterol – a problem that Zetia and Vytorin were designed to address.

Well, it looked good on paper.

A few years ago, Merck and Schering-Plough (the drug makers that market Zetia and Vytorin jointly) launched a two-year study called “Enhance” to test their drugs on 720 patients with high cholesterol. The trial was completed in April 2006, and the results were scheduled to be announced in March 2007.

So what was the hold up on the results? The official explanation is that the data from the study was so complex that it took nearly two years to figure it out.

Are you buying ANY of that? Me neither. I’m going to go out on a limb and guess that Merck and S-P executives realized they had a dud on their hands. And you don’t let a cash cow die if you can milk it for an extra year or so.

Let’s dance!

Prepare yourself for some loopy logic. Caution: May cause dizziness.

On Good Morning America, Diane Sawyer put this question to ABC medical editor Dr. Tim Johnson: “Okay – bottom line question this morning: Zetia or Zetia as part of Vytorin – should Americans plan to stop taking it?”

Dr. Johnson: “I don’t think they have to stop taking it. The question is should they have started it in the first place? And they should talk to their doctor if they are taking it.”

Then, a moment later, after singing the praises of statin drugs like Zocor, Dr. Johnson added: “I believe we should use statins as the first line drugs and save Zetia only for people who either can’t take statins because of side effects or for some reason won’t take statins.”

Okay. Let me get this straight. If a doctor can’t persuade a patient to take a statin, he should prescribe Zetia – a drug that costs about $3 per day, but doesn’t lower the risk of developing heart-stopping arterial plaque? And this advice comes just moments after Dr. Johnson has asked if patients should even have started it in the first place?

Dr. Johnson’s strategy seems to be this: Don’t let that patient out of the office without a prescription for SOMETHING! Even if it’s a prescription for something that doesn’t work.

Dr. Steven Nissen (chairman of cardiology at the Cleveland Clinic) had a similar message. He told the New York Times that the Enhance study provided “as bad a result for the drug as anybody could have feared.” And he added that patients should not be prescribed Zetia unless all other cholesterol drugs have failed.

And when the Zetia doesn’t work (as predicted by the research), doctors will have to break the bad news to their patients: Time to change your diet and start exercising.

Of course, neither Dr. Nissen nor Dr. Johnson addressed two nagging questions:
1) If Zetia lowers cholesterol, why doesn’t it stop plaque buildup and heart attacks?
2) When Zetia is combined with a proven cholesterol-lowering drug, why does plaque increase instead of decrease?

My prediction: We’ll never get answers to those questions because the medical mainstream will simply ignore them and get on with doing the primary job they do so effectively: pushing drugs, whether they’re effective or not.

Sources:
“Drug Has No Benefit in Trial, Makers Say” Alex Berenson, The New York Times, 1/14/08, nytimes.com
“Anti-Cholesterol Drug Bombs In Tests” The Associated Press, 1/14/08, ap.org
“Cholesterol Drugs Questioned” Good Morning America, 1/15/08, abcnews.go.com

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