Two drugs lower cholesterol better than one

Treatment with the combination of the drugs ezetimibe and simvastatin, sold as one pill called Vytorin, is more effective than atorvastatin (Lipitor) at lowering LDL cholesterol, the "bad cholesterol," according to a report in the American Heart Journal.

"Vytorin provides superior LDL cholesterol reduction to Lipitor across the dose range and at the usual start dose comparisons," Dr. Joanne Palmisano from Merck & Co. Inc., West Point, Pennsylvania told Reuters Health. And more patients reach their treatment goal with Vytorin than with Lipitor, she added.

Palmisano and colleagues compared the effects of Vytorin and Lipitor in a 6-week study of 1,902 patients with high cholesterol.

Across the dose ranges, the authors report, patients treated with Vytorin experienced significantly greater reductions in LDL cholesterol than did patients treated with Lipitor.

Patients treated with Vytorin also experienced significantly greater increases in HDL cholesterol, the "good cholesterol," than did patients treated with Lipitor, the results indicate.

Nearly 90 percent of patients given Vytorin achieved their treatment goal by the end of the study, the researchers note, compared with 81 percent of the Lipitor-treated patients.

The frequency of side effects was similar for the two treatments, the report indicates.

Vytorin provides better LDL cholesterol reduction at a lower price compared to 20 milligrams Lipitor, which is the usual starting dose, Palmisano said.

"Longer-term studies have been conducted with the combination of Vytorin as part of the development program for registration of the Vytorin tablet and there is excellent retention of the LDL cholesterol-lowering efficacy with continued long-term therapy," Palmisano added.

Vytorin lowers cholesterol through two mechanisms, she explained, by reducing cholesterol formation, which is done by the simvastatin component, and by reducing cholesterol absorption from the intestine, which is done by the ezetimibe component.

SOURCE: American Heart Journal, March 2005.