Attempts at lowering cholesterol in the pharmaceutical world are an ongoing process; every year scores of new drugs enter development and testing. Some pass through trials and others are abandoned at that stage. A recent product called Evacetrapib was recently canned following its preliminary human trials.
The drug was developed by Eli Lilly, who pitched it as a healthier alternative to the typical statin drugs. After the first trials, however, its side effects far outweighed the good elements. It reduced LDL cholesterol levels (the “bad” cholesterol) and increased HDL cholesterol levels (the “good” cholesterol), yet of those who participated
256 had heart attacks (compared to the placebo group that experienced 255), 92 had strokes (the placebo group experienced 95), and 434 died from cardiovascular disease (444 died in the placebo group.)
“We had an agent that seemed to do all the right things,” said Dr. Stephen J. Nicholls, the study’s principal investigator and the deputy director of the South Australian Health and Medical Research Institute in Adelaide. “It’s the most mind-boggling question. How can a drug that lowers something that is associated with benefit not show any benefit?” he said, referring to the 37 percent drop in LDL levels with the drug.
Evacetrapib works by siphoning cholesterol out of HDL, a cholesterol-carrying scavenger protein, so the cholesterol can be discarded through bile. Statins, in contrast, pull cholesterol from the other major cholesterol-carrying protein, LDL, into the liver, after which it can be discarded.
Researchers are pushing towards new statin alternatives (called PCSK-9 inhibitors) that lower LDL levels in the same way as statins. These drugs are much more costly than statins, however, with a $14,000 annual price tag attached.
As these alternative cholesterol-lowering drugs continue to be developed, statins remain the only option for those trying to handle their HDL levels. At the same time, evidence continues to mount reporting statin side effects. Statins prevent heart attacks for 1 in 60 and prevent strokes for 1 in 263. That means, the chances of statins preventing a heart attack only happens to 1 person out of 60, while 29% of people who begin taking statins report that they subsequently develop muscle pain.
The true efficacy of statins is still up for debate, and in the last year two major medical journals came to blows over the matter. The British Medical Journal (BMJ) and the Lancet offered two opposing views on the efficacy of statins; interestingly, one was funded by a statin manufacturer, the other by a statin alternative manufacturer.
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