This quarter also saw the results of ENHANCE study being published.
ENHANCE revealed no effect on Carotid Intima thickness, a surrogate marker of atherosclerosis, inspite being able to lower cholesterol. This trial has been a big blow to the drug which is prescribed in combination with statins.
Both the editorials published in NEJM on the trial advise clinicians to consider Niacin, fibrates, and resins when diet, exercise, and a statin have failed to achieve the target. Ezetimibe to be reserved for patients who cannot tolerate the above agents.
Now a larger trial IMPROVE IT is being conducted with 18000 participants and being studied for harder end points (in research parlance - clinical events like stroke, MI, death).Results of IMPROVE IT are expected in 2012.
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