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Niacin shrinks artery plaque; Merck's Zetia does not and may carry risks, new study finds

November 16, 2009

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RATING:

The story provides a reasonable amount of information on the study and places it in context of other studies and in context of other treatment options.

Our Review Summary

Overall, a reasonably complete story that addressed our criteria.  The story provides a reasonable amount of information on the study and places it in context of other studies and in context of other treatment options. 


 

Click on Criteria for definitions.

The story made it very clear that the medications discussed are all currently commercially available.

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Discuss costs? - SATISFACTORY

A cost for the medications discussed was provided; in addition the story noted that niacin was available in a less expensive, generic version.

The story did not engage in overt disease mongering.

The story provided information about the study in a piece meal fashion which included the number of individuals studied and that the study was stopped early because one group appeared to be faring better than the other with respect to size of carotid plaque.  A comment from a representative of the other drug makers mentioned that the end point (size of plaque buildup in the carotid) needs to followed up on because in and of itself does not have a health impact.  Coming from him it almost seemed as though it was sour grapes, but it is a very valid concern for interpreting the results of the study. It would have been better to have a less involved expert comment on the surrogate endpoint/

The side effect, flushing, associate with naicin was mentioned in the story as well as an estimate (1/3 of those taking Niaspan) for how many in the study were affected.  

None of the medicines discussed in this story are new or novel and they were not presented as such.

The story adequately discussed the benefits observed in this study, in a somewhat scattered fashion.  It mentioned the difference in heart attacks and other heart problems observed and though they were few, the difference was  statistically significant.  

The story does note the issues related to the surrogate endpoint and puts the study into context.  The use of a spokesperson from the manufacturer of eztimibe in comments on the value of the surrogate endpoint is curious and takes away from the legitimate discussion on its value.  This is offset somewhat by the comments of another presumably less conflicted expert.

 

Does not appear to rely exclusively on a press release.

Comments from several expert sources outside of the study investigators or the manufacturer of the drug that appear to provide a better outcome were included in this story.

The story discussed several of the available medications that could be used in addition to statins to lower heart attack risk.

 It might have been useful to include some information about dietary and lifestyle changes that could also be used to lower heart attack risk.

Total Score: 10 of 10 Satisfactory

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