- Associated Press - Wednesday, November 17, 2010

CHICAGO (AP) | For more than a decade, millions of lives have been saved by statin drugs such as Lipitor and Zocor, which lower bad cholesterol and the risk of heart attacks.

The drugs were so safe and worked so well that deaths from heart disease began falling dramatically. Doctors only partly joked about putting statins in the water supply.

Now they think they may be on to something even bigger.

An experimental drug, called anacetrapib, boosted good cholesterol so high and dropped bad cholesterol so low in a study that doctors were stunned and voiced renewed hopes for an entirely new way of preventing heart attack and stroke.

“We are the most excited we have been in decades,” said Dr. Christopher Cannon of Brigham and Women’s Hospital in Boston, who led the study of the novel drug for Merck & Co. “This could really be the next big thing.”

Anacetrapib will not be on the market anytime soon. It needs more testing to determine whether its dramatic effects on cholesterol will translate into fewer heart attacks, strokes and deaths.

Merck announced a 30,000-patient study to answer that question, and it will take several years.

But the sheer magnitude of the medicine’s effects so far excited lots of doctors at an American Heart Association conference in Chicago, where results were presented Wednesday.

“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.”

For years, doctors have focused on lowering LDL, or bad cholesterol, to cut heart risks.

Lipitor and Zocor do this, and generic versions of these statin drugs cost less than $1 a day.

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 them in the bloodstream to the liver for disposal.

The Merck-sponsored study tested anacetrapib 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 such as diabetes.

An LDL of 100 to 129 is considered good for healthy people, but patients like these should aim for less than 100 or even less than 70, guidelines say.

For HDL, 40 to 59 is OK, but higher is better. After six months in the study:

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

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

Such large changes have never been seen before, doctors said, and these improvements persisted for at least another year.

The Merck study was too small to tell whether anacetrapib lowered the rates of 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.

There were no signs of the blood pressure problems that led Pfizer to walk away from an $800 million investment in torcetrapib, a similar drug it was developing four years ago.

“This one looks far more potent, without the serious side effects that led to failure,” said Dr. W. Douglas Weaver, a cardiologist at Henry Ford Health System in Detroit and past president of the American College of Cardiology. “If proven effective, this will really change practice in the same way aspirin and statins have.”

Results of the study also were published online by the New England Journal of Medicine. Some study leaders have consulted for Merck and makers of other heart drugs.

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