VYTORIN vs. ZOCOR

For those of you on Vytorin or Zocor for your elevated cholesterol, you are probably quite aware of the study that was done comparing the two drugs head to head. Vytorin is a drug that contains Zocor and also contains Zetia which also reduces cholesterol. A study was done in Holland called the “enhanced trial” comparing Vytorin to Zocor. It found that Vytorin performed no better than Zocor in changing a biomarker of heart disease which is called carotid intimal media thickening (which is a sensitive non-invasive way to test plaque buildup). The study found that Vytorin lowered the cholesterol more than Zocor, which was expected. However, I looked at the details of the trial and I found that the carotid intimal media tests were not done properly. They were not gated - what I mean by that is that they have to be done at the time of an R wave of an electrocar-diogram because if they are not it can alter the results. The other thing that I found in this study is that the patients who were on the clinical trial had been on statin drugs for quite a period of time. Before the study began the statin drugs were stopped for six weeks which is called the washout period. Then they were put on Vytorin or the Zocor. A six-week washout is not enough to erase the benefits on the carotid intimal media test that were already accrued by their previous statin therapy.
This was a bad trial and what needs to be done is an outcome study to compare the patients on either Vytorin or Zocor with respect to heart attack, stroke, or death. Once that study comes out, then we can clarify this whole issue. The end result is that the patients who have been on Vytorin should continue to take it and the patients who have been on Zocor should continue to take it unless they have side effects.