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Trial Cholesterol Drug Strikes Out

Torcetrapib Fails to Slow Plaque Buildup in Arteries
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WebMD Health News
Reviewed by Louise Chang, MD

March 27, 2007 (New Orleans) -- Three new studies show that the novel cholesterol drug torcetrapib fails to slow plaque buildup in the arteries.

Torcetrapib was also recently linked to an increased risk of heart attacks and death. Additionally, the new drug may raise blood pressure, the research suggests.

Despite the setbacks, experts say there may still be a role for drugs similar to torcetrapib aimed at preventing heart disease by raising "good" HDL cholesterol.

In December, Pfizer Inc. announced it was stopping clinical trials of torcetrapib because of the increased heart risks associated with its use.

But researchers are continuing to analyze previously accumulated data in hopes of finding out why the drug failed.

Approach Still Promising

“A lot of people think it's the next big thing, so we need to understand what went wrong with torcetrapib to move forward,” says Steven Nissen, MD, head of cardiovascular medicine at The Cleveland Clinic and president of the American College of Cardiology (ACC).

“We believe the failure doesn't necessarily rule out the possibility that another drug in the class, one that is completely clean, with no blood pressure effects and no other evidence of toxicity, could possibly work," he tells WebMD.

Nissen notes that if Baycol had been the first statin tested and research had stopped after safety problems emerged, statins would never have been developed. Baycol, sold by Bayer AG, was withdrawn from the market in 2001 after reports of a severe and sometimes fatal muscle disorder.

“We don’t want to abandon a potentially lifesaving drug, but the bar has been raised. We have to move forward carefully,” he says.

A Strategy of Boosting HDL

Doctors say there is an urgent need for drugs that fight heart disease in novel ways. While credited with making a substantial dent in heart disease, statin drugs that lower "bad" LDL cholesterol don’t help everyone: Some statin users suffer heart attacks anyway.

“You could put statins in the blood supply, and cardiovascular disease would still be the leading cause of death. We need something else,” Nissen says.

That’s why doctors have been trying to boost levels of HDL cholesterol, which ferries cholesterol from the bloodstream to the liver where it can be disposed of.

Torcetrapib works by inhibiting an enzyme responsible for transforming good cholesterol into bad cholesterol. “If you block this enzyme, HDL goes up and LDL goes down,” Nissen says.

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Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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