Tag Archives: torcetrapib

Assessing the clinical benefits of drugs for dyslipidaemia Dear Sirs, A recent editorial in the New England Journal of Medicine1 highlights several challenging issues in the development of new treatments for lipid disorders. There is now uncertainty regarding the regulatory approach of approving drugs on the basis of favourable lipid effects and evaluating clinical benefit after approval. In numerous trials and several meta-analyses of outcome trials, the reduction of low-density lipoprotein (LDL) cholesterol has been shown to be associated with outcome benefit.2–4 Most of these studies have been performed with statins. The first demonstrat

While the failure of the first cholesterylester transfer protein (CETP) inhibitor, torcetrapib, was blamed on its side effect of raising blood pressure, three more negative trials have also now cast doubt on the value of boosting HDL – AIM-HIGH with niacin, dal-OUTCOMES with dalcetrapib, and a genetic study published earlier this year in The Lancet, showing that people carrying gene variants coding for increased HDL levels did not have a reduced risk of heart disease. However, in a new analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), published on July 11 in the Journal of the American College of Cardiology (http://dx.doi.org/10

ARISTOTLE: apixaban superior to warfarin in AF patients Another oral anticoagulant has shown good results in comparison to warfarin for use in the prevention of stroke in patients with atrial fibrillation (AF). The new oral factor Xa inhibitor, apixaban, was superior to warfarin in preventing stroke or systemic embolism and was also associated with less bleeding and lower mortality than warfarin in the ARISTOTLE trial. Apixaban is the third of the new generation of oral anticoagulants to be tested in this indication, and seems to have performed the best. The other two agents – dabigatran and rivaroxaban – have also been shown to be viable

Prasugrel lowers events but increases bleeding compared with clopidogrel in PCI patients The new antiplatelet agent, prasugrel, reduced ischaemic events compared with clopidogrel but at the cost of an increase in major bleeding in the TRITON-TIMI 38 trial in acute coronary syndrome (ACS) patients scheduled for percutaneous coronary intervention (PCI). Overall mortality did not differ significantly between the two groups. In the study, which has also been published in the New England Journal of Medicine, prasugrel prevented 23 myocardial infarctions (MIs) for every 1,000 patients treated but caused an excess of six non-CABG (coronary artery by