34 Cardiovascular Medicine I NTERNAL M EDICINE N EWS • May 1, 2007 Torcetrapib Fails to Slowed Progress Halt Of Carotid Atherosclerosis BY MARY ANN MOON sion of carotid atherosclerosis, as it has BY MARY ANN MOON 910 patients with known coronary ather- Contributing Writer been shown to do in previous studies in- Contributing Writer osclerosis. The subjects were randomly as- AND BETSY BATES volving patients with more advanced AND BETSY BATES signed to receive either plus Los Angeles Bureau disease, they added. Los Angeles Bureau torcetrapib (464 subjects) or atorvastatin “This was focused on low-risk partici- plus placebo (446 subjects) for 2 years, said N EW O RLEANS — Rosuvastatin pants without advanced atherosclerosis, N EW O RLEANS — Torcetrapib pro- Dr. Nissen of the Cleveland Clinic. slowed the progression of carotid intima- and this may have limited the opportuni- foundly raised HDL values and Adding torcetrapib to the induced media thickness in asymptomatic sub- ty to achieve disease regression,” Dr. decreased LDL cholesterol levels, yet failed an unparalleled 60% rise in HDL choles- jects at low risk of cardiovascular events Crouse said at the meeting, which was to halt the progress of atherosclerosis in terol and a 20% decline in LDL choles- but who nonetheless had subclinical ath- also sponsored by the Society for Cardio- two separate international trials, Dr. Steven terol, relative to atorvastatin alone. erosclerosis, Dr. John R. Crouse III re- vascular Angiography and Intervention. Nissen said at the annual meeting of the “Thus, at the end of 24 months, treat- ported at a conference sponsored by the LDL cholesterol declined by 49% and American College of Cardiology. ment with torcetrapib resulted in an av- American College of Cardiology. HDL cholesterol increased by 8% among The combined conclusions of the stud- erage HDL level that was actually higher The agent “basically halted progres- patients taking rosuvastatin. ies led Dr. Nissen, one of the trial investi- than the LDL level, with an LDL to HDL sion” of intima-media thickness, Dr. The frequency of adverse events was gators and president of the ACC, to con- ratio of 0.93: a ratio never before achieved Crouse said during a late-breaking clini- similar between the two groups, and most clude, “At this point, obviously, this in any major ,” Dr. Nissen said cal trials session at the meeting. effects were of mild or moderate severity. molecule is dead.” in his presentation. However, it also in- Unlike previous clinical trials of the In an editorial comment accompany- Investigators remain puzzled why the duced a “substantial” increase in systolic drug involving high-risk subjects or pa- ing the published report, Dr. Michael S. investigational cholesterol ester transfer blood pressure of 4.6 mm Hg, he said. tients with known , Lauer of the Cleveland Clinic Heart Cen- protein inhibitor, which led to unparal- Further, percent atheroma volume, the the METEOR (Measuring Effects on In- ter said, “At first glance, the METEOR leled increases in HDL cholesterol, failed primary efficacy measure, was not affect- tima-Media Thickness: An Evaluation of findings suggest that there may be a role to reduce atheroma volume on carotid ed. Neither was progression of athero- Rosuvastatin) trial assessed asymptomatic for routine arterial imaging” in low-risk ultrasounds. sclerosis in the most diseased segment of people aged 45-70 years who were at low people, and that routine rosuvastatin In a late-breaking the target artery, a cardiovascular risk and had only moder- therapy may be warranted for those clinical trial session Although secondary