Merck & Co and Schering-Plough’s combination cholesterol-lowering medicine, Vytorin (ezetimibe/simvastatin), is better at lowering the so-called “bad” LDL-cholesterol than Pfizer’s number one offering, Lipitor (atorvastatin), according to newly presented trial data.

The six-week study included some 1,902 patients with high cholesterol and found that, at their respective starting doses of 10/20mg and 10mg, Vytorin decreased LDL-cholesterol levels by 51%, compared with 36% for those receiving Lipitor. In addition, 82% of high-risk patients on Vytorin reduced their cholesterol levels to below 100mg per deciliter, versus 47% of those taking Lipitor. Results from the study also showed that a 10/40mg dose of Vytorin decreased LDL cholesterol by 59%, compared to 49% for Lipitor at the 40mg dose in high-risk patients. In addition, 57% of the high-risk patients taking Vytorin 40mg reduced their LDL-cholesterol levels to below 70mg/dL, versus just 23% of the patients taking the higher Lipitor dose. US National Cholesterol Education Programme guidelines state that patients at “very high risk” of heart attack should target LDL cholesterol levels of less than 70mg/dL [[14/07/04b]].

Furthermore, the study showed that Vytorin increased the levels of the “good” HDL cholesterol by a greater degree than Lipitor. Vytorin 10/40mg and 10/80mg increased HDL-cholesterol levels by 9% and 7.6% respectively, compared to increases of 3.8% and 1.4% respectively in patients taking Lipitor 40mg and 80mg.

Vytorin won the coveted US Food and Drug Administration green light in July last year [[26/07/04a]]. It is the first compound to offer a dual approach to tackling high cholesterol levels – inhibiting its production in the liver and blocking its absorption from food. Lipitor is the world’s biggest-selling drug, pulling in annual sales of around $10 billion dollars [[17/01/05d]].