The top story from the conference is a clinical trial pitting Abbott Labs' (NYSE: ABT) Niaspan against Merck's (NYSE: MRK)
Zetia. The trial had its flaws, including that data was from just 208
patients, but Niaspan was the clear winner. When added to
cholesterol-lowering statins, Niaspan was able to decrease the
thickness of an artery wall -- a measurement of plaque buildup. Zetia
plus a statin didn't have an effect on the thickness of an artery wall.
It's a clear win for Abbott. Niaspan works by increasing "good" HDL
cholesterol, and the trial clearly shows that the changes in HDL
cholesterol have a positive effect on artery-wall thickness.
How bad the results are for Merck remains to be seen. Like Pfizer's (NYSE: PFE) Lipitor, AstraZeneca's (NYSE: AZN) Crestor, and older statins -- Merck's Zocor and Bristol-Myers Squibb's (NYSE: BMY)
Pravachol -- Zetia works by lowering bad LDL cholesterol. In fact, when
used in combination with statins, Zetia can lower LDL levels below the
level that statins can on their own.
The decrease in cholesterol levels didn't translate into a decrease
in the thickness of an artery wall, but that shouldn't come as much of
a surprise; last year's Enhance trial
showed the same thing. Since that trial, sales of Zetia and Vytorin,
which combines Zetia with Zocor, dropped 12% year over year in 2008 and
an additional 14% so far this year.
This trial is another nail in Merck's now-fully owned
cholesterol franchise's coffin, but we can't start the funeral
procession just yet. Cholesterol levels and artery-wall thickness are
secondary to what patients and doctors really care about: heart
attacks. Merck has a large trial testing the effect of Zetia on heart
attacks, but the results won't be available until 2012.
Until then, expect Zetia's and Vytorin's sales to bleed a little.
© 2009 UCLICK, L.L.C.
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