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Ezetimibe in ARBITER 6-HALTS: What lessons can we learn?

Posted Nov 16, 2009 at 05:00 PM, EDT by Eric Topol

Another trial has failed to show efficacy for ezetimibe. What can we learn from this unfortunate saga?

See:

ARBITER 6-HALTS: HDL raising with niacin superior to ezetimibe

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ARBITER 6-HALTS shows in a short period (14 months) a clinical (Kaplan-Meier estimates) and IMT benefits but What is the fastest mechanism of reverse cholesterol transport? increased HDL or decreased LDL. The baseline LDL levels in Ezetimibe and Niacin groups was almost 80 mg/dl, good target for secondary prevention. Long period trial using IVUS is needed to get conclusive results before killing ezetimibe.


Posted by Rafael Olvera MD, Nov 17, 2009 at 08:24 PM, EDT
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In patient discussions there are two principals that stand out.  If the procedure/pill/treatment does not make one feel better and or live longer, it should be questioned.  I think may be an ok alternative to I know as we do not know which patient will benefit and are happy if a small percentage does benefit.  When it is a matter of odds as to whether there is any benefit of a drug etc., is a multibillion dollar bet justified?


Posted by Gary Cramer, Nov 20, 2009 at 09:50 AM, EDT
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After this trial there is no justification for using ezitimibe. Especially as some people say that IMPROVE-IT is unlikely to be completed.
Posted by Alain Efstratiou, Dec 04, 2009 at 01:49 PM, EDT
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