Truth Under Attack At USA Today

  • by: |
  • 01/17/2008
Predictably USA Today pushes the panic button on Vytorin

But many doctors express frustration. They say they're increasingly asked to prescribe drugs like Vytorin, Zetia and Crestor though the drugs have never have been successfully tested in long-term trials. In the world of billion-dollar medicines, these have a nickname — "me-too" drugs, because they're purportedly like other drugs that have been more extensively tested.

Cholesterol-lowering drugs aren't the only culprits. A number of blood-pressure-lowering ACE-inhibitor drugs are riding on the coattails of the blockbuster Captopril. Zetia and Vytorin are me-too drugs that stretch the limits of the category. Although they were approved on the same basis as statins — for their power to lower bad cholesterol — they aren't statins. They work by an entirely new mechanism that Merck and Schering-Plough promote heavily to doctors and on television, though it's not as well-tested as the statin approach.

Doctors who prescribe them, and patients who use them, take it on faith that the drugs will protect them from heart attacks and prolong their lives, says Yale University cardiologist Harlan Krumholz.

"This is huge," he says. "It's a story of whether or not the profession is going to turn and say, 'We're not going to say me-too drugs are the same unless they prove it.' "

Meanwhile none of the articles picked up on the real reason why most drugs don't work for most people: genetic variations. Nor did they link this story to another important scientific one about cholesterol reported last week.

7 New Cholesterol Genes Found
Genes May Make Good Targets for New Cholesterol Drugs, Experts Say
By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD

Jan. 14, 2008 -- Scientists have discovered seven genes that affect levels of HDL ("good") cholesterol, LDL ("bad") cholesterol, and triglycerides (another type of blood fat).

Several of those genes "are potentially attractive drug targets" to lower heart disease risk, write the University of Michigan's Cristen Willer, PhD, and colleagues.

Two of the newly identified genes only affect HDL cholesterol, one only affects LDL cholesterol, three only affect triglycerides, and one affects LDL cholesterol and triglycerides.....

....Willer and colleagues also noticed that genes for high LDL cholesterol levels were associated with greater risk of coronary artery disease, which makes heart attacks more likely.

"Nearly all of the gene regions that we found to be involved in higher LDL levels were also involved in coronary artery disease risk," Willer states in a news release. "This is a remarkable result and suggests that new drug therapies that target the genes in these regions will also help prevent coronary artery disease and allow people to live longer and healthier lives."

One day, it may be possible to tailor cholesterol and triglyceride treatments to a patient's gene profile, the researchers note.

Meanwhile, your doctor can check your cholesterol and triglyceride levels and give you advice about how to improve those levels through diet, exercise, and medication, if needed.

Not one article or news account discussed this important factor. It's easier just to make people panic and pick up on the old "me-too" drug issue.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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