Ezetimibe's Rapid U.S. Adoption Called Flawed

The results reported last year from a clinical outcomes trial of torcetrapib “really chastened me,” Dr. Krumholz said. Torcetrapib had shown potent, positive effects for raising levels of HDL cholesterol while also lowering LDL cholesterol and seemed safe and well tolerated. But then the trial results showed that torcetrapib raised blood pressure in many patients and boosted the study group's mortality rate, which led to the study's early halt.

The fourth panel member was Dr. Rick A. Nishimura, professor of medicine at the Mayo Clinic, Rochester, Minn., and a member of the guidelines task force for the ACC and American Heart Association. Revised lipid-management guidelines that reflect the new findings on ezetimibe could be released by the end of this year, he said.

The day after the ENHANCE report, a statement from the ACC and American Heart Association said: “The study reinforces the need to adhere to current American College of Cardiology/American Heart Association guidelines, which recommend statins to the maximally tolerated dose or to goal as first-line treatment for patients with coronary artery disease.”

On the same day, Congress renewed its pressure on the drug manufacturers. (See box.)

'The strongest recommendation we can make is turn back to statins.' DR. KRUMHOLTZ