A new study brings a new blow to Zetia (ezetimibe). In a recent study published by the New England Journal of Medicine, it appears that taking the extended release form of a common supplement, niacin, works better in reducing atherosclerotic plaque thickness than Zetia, a newer cholesterol drug that is used to specifically lower LDL cholesterol.
High LDL levels, coupled with inflammation in the inner walls of arteries, lay down the foundation for developing heart disease. This process, known as atherosclerosis, can cause lipids within the vessel to build up into a thick plaque. Eventually, this plaque could limit - or even obstruct - blood and nutrients to vital organs.
The study examined 208 participants who had established heart disease or an equivalent to it. These individuals were already taking a statin, but were randomized to also take either extended-release niacin (Niaspan) or Zetia. The researchers measured carotid intima-media thickness in order to assess changes in plaque thickness from taking the drugs over a 14-month period.
The study found that niacin reduced plaque thickness in the carotid arteries. While Zetia also appeared to reduce plaque thickness, it was very slight and not a significantly different from the baseline measurement. Zetia also lowered LDL cholesterol slightly more than niacin, however niacin also raised HDL cholesterol.
While we need more studies to examine the effectiveness of Zetia and its role in preventing heart disease (heart attacks, strokes), studies like this cause us to question if Zetia really has a place.
More about the Zetia saga:
Source: Taylor AJ et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. NEJM 2009;361:1.
number, NCT00397657.)
