The news has recently been full of discussion about the drugs Vitorin and Zetia, which have been used to treat high blood lipids that cause heart disease and circulaton problems. What does this mean to you, if you or a loved one are on one of these medicines?
First of all, it is important to realize that there is no danger. The medicines Vitorin and Zetia have not been shown to cause unusual risk or harm, but the problem is, they may not work as well as had been hoped.
The findings are from the Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression (ENHANCE) study, and they were presented at the American College of Cardiology (ACC) 57th Annual Scientific Session. Researchers had hoped to improve changes in blood vessel blockage and narrowing from high cholesterol by using Vitorin (a combination of simvastatin-ezetimibe), but this regimine failed to show any improvement beyond that achieved with the simvastatin alone. Simvistatin is also available by itself, and is also known by the brand name Zocor.
These findings were a big surprise to doctors, because the addition of ezetimibe to simvastatin did lead to much lower values of cholesterol, low-density lipoprotein [LDL] cholesterol and C-reactive protein, which are the lab tests that doctors do to see how the drugs are working.
Ongoing studies are now underway to answer the real question that we all care about, which is, does this drug combination do a better job of preventing death from heart disease? Right now, we just do not know. The changes seen in the carotid arteries in the ENHANCE study are just a surrogate measurement for this vital question.
What should someone do now, if they are taking one of these drugs? The first thing to do is to make an appointment with your own physician to discuss your personal situation, and do not change your medication on your own. Vitorin should not be a first line drug to treat high cholesterol, since a pure statin drug may work as well, and it will be less expensive and a simpler treatment. If you have been titrated up to the maximum dose of a statin, and then have also had Zetia added in order to get your lab test to goal, that is a harder problem. We do not know right now if that will be more helpful or not, and the decision should only be made after careful consideration and discussion.