Raising Good Cholesterol Fails to Cut Heart Attacks ; Studies Also Find New Drugs Have Safety Issues

Mar 27, 02:20 PM

Current Headlines: By MARILYNN MARCHIONE, THE ASSOCIATED PRESS

NEW ORLEANS The hot new strategy of trying to prevent heart disease by raising good cholesterol had more setbacks Monday as new studies showed that experimental drugs didn't work and also had safety problems.

The news follows Pfizer Inc.'s abandonment in December of an $800 million investment in torcetrapib, the leading contender in this class of drugs, because it raised the risk of heart attacks and deaths. Heart specialists have been anxious to know whether the problems extend to all such drugs and doom this approach.

"A lot of people think it's the next big thing, and we'll need to understand what went wrong with torcetrapib to move forward," said Dr. Steven Nissen, a Cleveland Clinic heart specialist and president of the American College of Cardiology.

The new studies, reported at the group's conference, gave a mixed answer. The Pfizer drug seems uniquely risky, but other drugs have problems, too.

And even though they and the Pfizer drug raised HDL good cholesterol as intended, that made no difference in the odds of heart attacks or deaths, or key mea- sures of cholesterol buildup in arteries.

Doctors long have focused on lowering LDL, or bad cholesterol, to cut heart attack risk. Statins, sold as Lipitor and Zocor and also in generic form, lower LDL, which ferries fats from food into the bloodstream.

But many statin users suffer heart attacks anyway, so doctors have been trying to boost HDL, or good cholesterol which transports fat from the blood to the liver to be disposed of to further lower risk.

An extended-release niacin drug called Niaspan, sold by Kos Pharmaceuticals Inc., does this. But it can cause a prickly hot sensation called flushing that some people find intolerable. Pfizer, Merck & Co. and Swiss drug maker Roche Holding AG are testing drugs that boost HDL in a novel way.

In several studies, there were hints of some improvements in less important measures of artery buildup, which provides "a glimmer of hope for future development of this class of drugs," Dr. Alan Tall of Columbia University writes in an editorial in the New England Journal of Medicine.

That journal and the Journal of the American Medical Association published reports based on several of the new studies.

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