'Unprecedented': Cholesterol drug called dramatic success

From: 'Unprecedented': Cholesterol drug called dramatic success (http://www.suntimes.com/lifestyles/health/2904212,CST-NWS-cholest18.article)

November 18, 2010

BY MONIFA THOMAS Health Reporter/mjthomas@suntimes.com

An experimental drug dramatically boosted "good" cholesterol while slashing "bad" cholesterol in a major study whose results have experts predicting the drug could be the next big thing in fighting heart disease.
The new drug -- called anacetrapib -- still has to be tested in a larger trial to determine whether it reduces heart attacks, stroke and other cardiovascular events.
But the results from the long-awaited DEFINE trial, presented Wednesday at an American Heart Association conference at McCormick Place, were "unprecedented," according to the lead researcher, Dr. Christopher P. Cannon of Brigham and Women's Hospital in Boston.
"There are very few drugs available to treat low levels of good cholesterol, and this new drug, anacetrapib, is 4 to 10 times more effective in raising good cholesterol compared to current therapies," Cannon said.
If it lives up to its early promise, anacetrapib could be a powerful addition to statin therapy for people at risk for heart disease, said Dr. Doug Weaver, past president of the American College of Cardiology and head of cardiology at Henry Ford Hospital in Detroit.
"Statins don't do it all, and so this really could be a game-changer if proven to be clinically effective," said Weaver, who was not involved in the research. "It could be as big as statins were."
Cholesterol-lowering statin drugs effectively reduce levels of "bad" cholesterol, also known as LDL. But "a lot of people die [of heart disease] even though we have all these statins available," Cannon said.
So a key goal has been to find ways to also increase levels of "good" cholesterol, or HDL, which removes cholesterol from the arteries and transports it to the liver, where it's passed from the body.
When taken with statins, anacetrapib raised HDL levels 138 percent and cut LDL 40 percent, compared with a placebo, the study found.
Patients treated with the drug also didn't experience the dangerous side-effects that doomed an earlier drug in the same class, torcetrapib.
The 18-month DEFINE trial, which involved 1,600 patients with well-controlled LDL levels, was funded by the drug's manufacturer, Merck.
A much larger, four-year study of anacetrapib announced Wednesday should answer many of the lingering safety and efficacy questions.
Anacetrapib belongs to a class of drugs known as cholesterol-ester-transfer-protein -- or CETP -- inhibitors. The only other drug that has been shown to raise HDL is niacin, a form of Vitamin B. But the side effects, which include skin flushing and itching, can be intolerable, and its effect on raising HDL is modest, Weaver said.