Vytorin more effective than simvastatin in lowering cholesterol in some patients

Cholesterol lowering drug Vytorin, a statin made by Merck & Co., reduced risk of cardiovascular disease or events such as myocardial infarction and stroke in patients with chronic kidney disease by 17 percent, a new clinical trial showed. 

Vytorin is comprised of a combination between Zetia and Simvastatin, two individual statins.  But critics said the clinical trial compared vytorin with a placebo and it did not prove that adding Zetia to simvastatin increases the efficacy. 

But at least in patients with type 2 diabetes or coronary heart disease, addition of Zetia to simvastatin boosts the efficacy of the drug in reducing serum cholesterol levels. The real efficacy in reducing heart risk remains unknown. 

One trial published in the May 2010 issue of Cardiovascular Diabetology found a combination of 10 mg ezetimibe and 20 mg of simvastatin or vytorin 10/20 performed better than 40 mg of simvastatin in hyperlipidemic patients with type 2 diabetes mellitus and coronary heart disease. 

The study led by Bardini G and colleagues of the University of Florence in Florence, Italy was intended to examine the cholesterol-lowering effects of vytorin and a doubled dose of simvastatin in patients with hypercholesterolemia and coronary heart disease.  

In the study, adult patients with type 2 diabetes mellitus and coronary heart disease were randomly assigned to take either vytorin or simply 40 mg of simvastatin for six weeks. 

The reduction in the bad cholesterol was found greater in those taking vytorin by 10/20 than those taking the higher dose of simvastatin: 32.2 percent versus 20.8 percent. Also, reduction in total cholesterol was also greater in those taking vytorin than among those taking simvastatin:  20.6 percent versus 13.2 percent. 

Additionally, 78.4 percent of patients on vytorin lowered LDL cholesterol to less than 2.6 mmol/L,compared to 60 percent of those on 40 mg of simvastatin. The difference was not significant, however. 

There was no difference between the two treatments in terms of their effect on high density lipoprotein cholesterol and triglycerides. 

The researchers concluded these results demonstrate that vytorin is more effective in reducing cholesterol in hyperlipidemic patients with type 2 diabetes mellitus and coronary heart disease.

Jimmy Downs and editing by Rachel Stockton