In a blow to combo cholesterol pills, researchers found that there's no proof that two cholesterol drugs are better than high doses of one. The researchers analyzed 102 studies, finding little evidence that combination meds such as Merck/Schering-Plough's Vytorin and Abbott Laboratories' Simcor extended life expectancy any better than a single statin. In part that's because the companies didn't study combo meds nearly long enough to determine long-term benefits.
So, docs might want to stick to statins, lead author Mukul Sharma told Bloomberg, which are proven to show a long-term benefit. "There is a dearth of evidence," Sharma said. "Any time you combine medicines you increase the expense and you increase the possibility of side effects."
But for drugmakers, increasing the expense is the point. Statins are falling off patent. Combining them with other agents such as the Zetia in Vytorin or the niacin drug Niaspan in Simcor creates new branded products without cheap generic competition.
Merck and Abbott argue that statins alone aren't enough for many patients. After poking some holes in the new study's methodology, Merck pointed out to Bloomberg that the researchers "did conclude that statin-ezetimibe [Zetia] combinations are more likely to result in attainment of goals" for blood lipids. An Abbott spokeswoman told the news service that fewer than one patient in three now taking cholesterol meds reaches targets for LDL, HDL and triglycerides. "Treatment guidelines recommend combination therapy for certain patients whose LDL is under control, but who need additional lipid management for HDL an triglycerides," she said. Sounds like the combo meds are simply crying for outcomes studies.