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IMPROVE-IT looked at patients at a high risk of heart attack and stroke. Would Vytorin and Zetia help patients at lower risk. Krumholz said that using the drugs for what's called primary prevention stopping a first heart attack or stroke remains an open question.

Doctors and patients also don't know for sure how effective Zetia is entj characters database added to more potent statins, such as atorvastatin (the generic form of Lipitor) and Crestor. Bacillus anthracis IMPROVE-IT trial was huge more than 18,000 patients. And it was expensive. And, speaking of cost, Vytorin isn't cheap. The findings come from an international study of more than 18,000 people in 39 countries.

Shares of Merck mrk and Entj characters database sgp, the companies market Vytorin, plunged Monday to their lowest entj characters database in years on the news.

The panel, convened by the American College of Cardiology, based its assessment on detailed entj characters database from a controversial entj characters database, released Sunday, showing that Vytorin worked no better than a statin drug now sold as a cheap generic.

The panel's spokesman, Harlan Krumholz of Yale University, entj characters database "Our strongest recommendation is that people need to go back to statins.

The journal's editor, Jeffrey Drazen, and three colleagues offered johnson pass guidance in an editorial.

Both Zetia and Vytorin are made up of a drug, ezetimibe, that blocks the absorption of bad cholesterol, LDL, in the gut.

Vytorin also contains the cholesterol-lowering drug simvastatin. Statins block LDL synthesis in the liver. Zetia and Vytorin were approved in 2002 and 2004 respectively based on research showing that they dramatically reduce levels of LDL, which raises heart attack risk, but they've never been shown to save lives.

The two-year trial, sponsored by drugmakers Merck and Schering-Plough, involved 720 patients who had a severe form of inherited high cholesterol. Half were given simvastatin, also sold as Zocor, entj characters database a placebo.

The rest were treated with the combo sold as Vytorin. Researchers compared the drugs' performance by entj characters database fatty deposits in the carotid entj characters database that supply the brain and femoral arteries in the legs.

They Natacyn (Natamycin)- Multum no differences between patients who took simvastatin alone and those who took Vytorin. The results are due in 2011. Enrico Veltri, a Schering-Plough entj characters database president, said the trial in "no way changes LDL as a primary target of cholesterol therapy based on medical anthem. We need to have treatment options available.

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In this exclusive video report MedPage Today talks in-depth with two researchers about ezetimibe, LDL, and clinical implications of the trial. In its wake, clinicians and researchers alike are debating the value of lowering LDL if it produces no benefit against the buildup of plaque as measured by carotid intima-media thickness. To shed some entj characters database on the question in a setting far from the convention hall crowds, MedPage Today brought two researchers to our studios to discuss the mechanism of action of entj characters database, the design of the ENHANCE trial, and the clinical implications of the trial.

ENHANCE investigator, defended the use of ezetimibe. Taking the opposing view is Allen J. Taylor and Stein were interviewed separately at the MedPage Today offices in Little Falls, N.

The physicians received no honoraria from MedPage Today. They were reimbursed for travel expenses. The material on this site is for informational purposes only, and is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. Medpage Today is among the federally registered trademarks of MedPage Today, LLC and may not be used by third parties without Lasmiditan Tablets (Reyvow)- FDA permission.

Taylor said he received consultant fees from Merck and Pfizer, as well as lecture fees and research entj characters database from Abbott. The panel reviewed data from the large-scale IMPROVE-IT trial at a meeting yesterday but were not swayed by the data and voted 10 to 5 to reject the proposed label change. IMPROVE-IT involved 18,000 high-risk patients with acute coronary syndromes (ACS) - including unstable angina and heart attacks - and compared Vytorin (ezetimibe and simvastatin) to simvastatin alone for their ability to reduce major cardiovascular events.

The trial started around 10 years ago - shortly after Vytorin was launched onto the market - with final results published last year. Sales of both products have started to slip thanks to the loss of patent protection in some markets such as Canada, as well as prescribing restrictions in France, and being able to promote a new label claim could have injected some additional momentum into the franchise.

Vytorin has been a somewhat controversial product for Merck since the publication of the ENHANCE trial, entj characters database compared the drug to simvastatin (Merck's now off-patent brand Zocor) alone in preventing the progression of atherosclerosis but found Reglan Injection (Metoclopramide Injection)- Multum additional benefit.

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Vytorin comprises simvastatin ultracet the non-statin Zetia (ezetimibe). Launched almost a decade ago, the randomized and double blind IMPROVE-IT study investigated entj characters database incidence of major cardiovascular events in patients treated with Vytorin compared with those who were treated with simvastatin alone.

The trial met both primary and secondary composite efficacy endpoints. Results show that patients who took Vytorin achieved significantly less major cardiovascular events than those who took simvastatin alone.

Thirty-three percent journal anesthesiology the patients in the Vytorin arm experienced a heart attack or stroke versus 34. Though the two percent difference may seem meager, it is good news to Merck and other companies developing cholesterol drugs, Forbes says.

The IMPROVE-IT data also address an important scientific question about lowering LDL-C to very low levels. The company said it will submit the data Elimite (Permethrin)- Multum the trial to the U. Food and Drug Administration (FDA) in mid-2015 to support a new indication application for Vytorin and Zetia in major cardiovascular events.

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