An unsuccesful statin trial

April 2008

In this week´s issue of The New England Journal of Medicine the report from the unsuccesful ENHANCE trial was published, almost two years after it had been terminated. Not unexpectedly, at least for those who have been informed by THINCS´ members, a further lowering of cholesterol by a non-statin drug did not improve the angiographic changes of the coronary arteries; on the contrary. Read Sandy Szwarc´s report!

In that trial cholesterol was lowered in two groups of people with familial hypercholesterolemia. Unexpectedly, at least to the trial directors, angiographic progress was the same in both groups, although cholesterol was lowered much more in those who were treated with two cholesterol lowering drugs. There is a logical explanation to that, unknown to most people, and it may remain so, at least for a while, because the editor of the New England Journal of Medicine didn´t find my comment of sufficient interest to their readers. The explanation is that it is not the high cholesterol that causes a few of the people with familiar hypercholesterolemia to die at a young age. Read my rejected letter

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