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Such large changes have never been seen before, doctors say, and these improvements persisted for at least another year that the study went on.
Over the years, other drugs have generated excitement in early research, then turned out to be risky or not so effective when tried on many more patients.
The Merck study was too small to tell whether anacetrapib lowered deaths, heart attacks or other heart problems. But the trend was in the right direction, with fewer of those cases among patients on the drug. The anacetrapib group also needed significantly fewer procedures to fix clogged arteries.
Importantly, there were no signs of the blood pressure problems that led Pfizer Inc. to walk away from an $800 million investment in torcetrapib, a similar drug it was developing four years ago.
"This one looks far more potent, without the serious side effects that led to failure," Dr. W. Douglas Weaver, a cardiologist at Henry Ford Health System in Detroit and past president of the American College of Cardiology, said of the new Merck drug. "If proven effective, this will really change practice in the same way aspirin and statins have."
Results of the study also were published online by the New England Journal of Medicine. Some study leaders have consulted for Merck and makers of other heart drugs.
Dr. Allen Taylor, a cardiologist at Washington Hospital Center, noted that study participants' bad cholesterol was twice as high as their good cholesterol before treatment, and that anacetrapib caused this to reverse: The good became double the bad. That's never been achieved before and is "a profound swing" that should lead to reversal of heart disease, not just slowing its progression, he said.
Taylor led major studies of the only other drug that has had major effects on bad and good cholesterol -- albeit much smaller than those from anacetrapib.
Niacin, a type of B vitamin, is sold by Abbott Laboratories in an extended-release version called Niaspan. It has been on the market since the late 1990s, but some people are bothered by a prickly hot sensation called flushing. Doctors say this side effect can be minimized by taking the drug at night with a low-fat snack.
Copyright 2010 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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