Next Big Thing For You?

Chances are if you're over 40, you’re hearing your cholesterol is approaching or surpassing the unhealthy level. This is especially true if your job is a sedentary one and your eating habits are this side of a Happy Meal.

If that’s so, then you should be interested in an experimental Merck drug that the Whitehouse Station, N.J.-based company says safely boosted good cholesterol to record highs and dropped bad cholesterol to unprecedented lows.

The study shocked researchers and boosted hopes for an entirely new way of lowering heart risks, according to The Associated Press.

“We are the most excited we have been in decades” about a novel drug, said the study's leader, Dr. Christopher Cannon, of Brigham and Women's Hospital in Boston. “This could really be the next big thing.”

The drug, anacetrapib (an-uh-SEHT'-ruh-pihb), won't be on the market soon because it needs testing to see if its dramatic effects on cholesterol will translate into fewer heart attacks, strokes and deaths. Merck & Co. announced a 30,000-patient study to answer that question, and it will take several years.

But the sheer magnitude of its effects so far caused big excitement at an American Heart Association conference in Chicago, where results were presented. Results of the study also were published online by The New England Journal of Medicine.

“The data look spectacular, beyond what anybody would have expected,” said Dr. Robert Eckel, a University of Colorado cardiologist and past president of the heart association. “It's like a rocket to Jupiter versus one to the moon. I can think of many of my patients who could use the drug right now.”

Merck’s timing in this study couldn’t be better. The cholesterol drug market is highly competitive, with sales exceeding $30 billion a year.

Some cholesterol drugs treat hereditary- and diet-related types, others deal with one or the other. The effectiveness of these drugs depends on individual situations; no one size fits all.

Still, major pharmaceutical companies, including Merck, have been looking for the “next big thing” since the statins – including Crestor, Lipitor, Pravachol, Zocor – started gaining acceptance in treating high cholesterol and, in some cases, reducing the risk for first heart attacks.

Statins are drugs that can lower your cholesterol, according to MayoClinic.com. They work by blocking a substance your body needs to make cholesterol.

Statins may also help your body reabsorb cholesterol that has built up in plaques on your artery walls, preventing further blockage in your blood vessels and heart attacks.

For years, doctors have focused on lowering LDL, or bad cholesterol, to cut heart risks. Statin medicines do this. But many statin users still suffer heart attacks, so doctors have been trying to get LDL to very low levels and to boost HDL, or good cholesterol.

Anacetrapib would be the first drug of its kind. It helps keep fat particles attached to HDL, which carries it in the bloodstream to the liver to be disposed of.

The Merck-sponsored study tested it in 1,623 people already taking statins because they are at higher than usual risk of a heart attack – half had already had one, and many others had conditions like diabetes.

An LDL of 100 to 129 is considered good for healthy people, but patients like these should aim for under 100 or even under 70, guidelines say. For HDL, 40 to 59 is OK, but higher is better.

After six months in the Merck study:

*LDL scores fell from 81 to 45 in those on anacetrapib, and from 82 to 77 in those given dummy pills.

*HDL rose from 41 to 101 in the drug group, and from 40 to 46 in those on dummy pills.

Such large changes have never been seen before, doctors say, and these improvements persisted for at least another year that the study continued.

The study was too small to tell whether anacetrapib lowered deaths, heart attacks or other heart problems, but the trend was in the right direction, with fewer of those cases among patients on the drug. The anacetrapib group also needed significantly fewer procedures to fix clogged arteries.

“We are trying not to be too giddy. The potential benefit is enormous,” said Dr. Luciano Rossetti, Merck senior vice president of global scientific strategy.

We, at WMB, applaud Merck and other pharmaceutical companies for efforts such as this because it's exactly the type of win-win that boosts industry and consumers, a marriage of financial and health benefits.

Anacetrapib could revolutionize the way we treat cholesterol problems and help prevent heart-related troubles – potential issues as we grower older, regardless of how well we maintain ourselves physically.

The kind of leadership shown by Merck in this endeavor underscores the need for all American companies, regardless of product, to think “outside the box” in advancing not only their bottom line but civilization.

The potential benefits of anacetrapib are global, and we are encouraged by the initial findings!

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