Ezetimibe is an ingredient in Zetia and Vytorin. These popular cholesterol-lowering medications have come under increasing scrutiny over the last few years because of concerns that they may not lower the risk of heart attacks and strokes as anticipated. Now a new study in The New England Journal of Medicine adds fuel to the fire. A head-to-head study with an old-fashioned, inexpensive cholesterol-lowering drug called niacin demonstrated that niacin was superior to ezetimibe.
The study measured thickening in the lining of carotid arteries. Although niacin shrank this thickening slightly, ezetimibe did not. What is more, even in this small study of about 200 people, more of those taking ezetimibe had heart attacks or died. As a result, the study was stopped prematurely.
Niacin has been used for decades to lower bad LDL cholesterol and raise good HDL cholesterol. And for decades doctors have known that it can prevent heart attacks. But niacin can be difficult to take at cholesterol-lowering doses, causing flushing, itching and tingling. This research may give niacin a fresh boost and cast a lengthening shadow on the purported benefits of ezetimibe.
[New England Journal of Medicine, Nov. 15, 2009]
The People's Perspective on Medicine