High-cost drug helps slash cholesterol in sick patients

A new cholesterol-lowering drug evolocumab helps high-risk patients reduce the likelihood of a heart attack or stroke, but its high cost raises questions about how many patients will benefit, researchers said today.
The results of a two-year clinical trial on the drug sold as Repatha by Amgen Phamaceuticals that costs more than USD 14,000 a year were released at the American College of Cardiology annual conference in the US capital.
The randomized trial involved 27,564 people who had experienced a prior heart attack or stroke, or who had significantly clogged arteries that limited blood flow to their limbs.
Evolocumab reduced low-density lipoprotein (LDL), or "bad" cholesterol, by 59 per cent.

It also decreased the risk of heart attack or stroke or cardiovascular death by 15 percent in the first year and 25 percent in the second year.
"The drug was safe and well-tolerated," said lead study author Marc Sabatine, chair of cardiovascular medicine at Brigham and Women's Hospital in Boston.

Experts not involved in the study described it as "exciting" and "major," but urged caution due to the high cost of the medication.
"This is very expensive stuff," said Valentin Fuster, physician in chief at Mt Sinai Medical Hospital in New York.
Fuster also noted that in absolute numbers, the drug saved about two percent of lives.

"We have to be very cautious in terms of the enthusiasm," he told reporters at the conference.
Roxana Mehran, professor of medicine at Mount Sinai School of Medicine in New York, described the findings as "probably the most important trial here" at the ACC meeting, which is the largest annual gathering of cardiologists in the United States.
"Certainly America cannot afford to be giving this to every patient," she added.
"While we don't want to ration great care, we do need to figure out how to pay for this.