For 24 years, patients have had a way to lower their "bad cholesterol" with medications.
But doctors are still struggling to find a drug that safely raises "good cholesterol," which carries bad cholesterol out of the blood.
A preliminary study, presented Tuesday at the American Heart Association meeting in Orlando, shows preliminary evidence that a new class of drugs might help.
The drug evacetrapib, part of a class of medications called CETP inhibitors, more than doubled patients' "good" HDL cholesterol, according to an early study of nearly 400 patients. The drug also substantially lowered "bad" LDL cholesterol. This class of drug "raises HDL cholesterol much more than any other drug we have in clinical practice," says the study's lead researcher, Stephen Nicholls of the Cleveland Clinic.
At the meeting, researchers showed that a similar drug, anacetrapib, improved patients' cholesterol levels, both during a 1-year study, and three months after stopping the drug.
Large population studies for years have shown that people with higher HDL are less likely to die from heart attacks, says Christopher Cannon, associate professor at Harvard Medical School, who co-wrote the anacetrapib study.
Doctors remain cautious. An earlier CETP inhibitor, torcetrapib, also looked good on paper, until studies showed it increased the risk of heart problems and death, says Cam Patterson of the University of North Carolina-Chapel Hill.
And another study, also presented at Tuesday's meeting, found that niacin, a mainstay of heart treatment for years, failed to reduce heart attacks, even though it boosted good cholesterol. Alarmingly, researchers found that users of niacin, or vitamin B3, had a slightly higher risk of stroke, although this could have been a coincidence.
The study, sponsored by the National Institutes of Health, was stopped after three years for "futility." That's disappointing, given that Americans spent $800 million a year on brand-name, extended-release niacin, writes Robert Giugliano of Harvard Medical School in an editorial accompanying the study in The New England Journal of Medicine Tuesday.
The niacin study "challenges all we know about good cholesterol," Cannon says.
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