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Statin therapy for children

August 6, 2008

Analysis of:8-Year-Olds on Statins? A New Plan Quickly Bites Back | www.nytimes.com

The potential market for treatment of lipids(cholesterol)continues to grow. Recent recommendations regarding potential for treatment of children as young as 8 are controversial, primarily because of the lack of data to demonstrate efficacy in terms of "hard" endpoints(i.e. mortality/MI)vs. morbidity of the therapy(i.e. cognitive dysfunction/growth delay). The intellectual underpinning of the rationale for drug therapy is this:diet/exercise are either inadequate and/or poorly complied with for many people, atherosclerosis starts sooner than most people realize, delaying therapy until adulthood may be too late to prevent the process(rather than simply arrest or reverse it). A very small group of people with relatively rare genetic predisposition to high cholesterol would be candidates for therapy in light of very premature cardiac event rate. In the absence of controlled trial data, we cannot assume that the beneifts of drug therapy outweigh the risks.

Avandia is going down the drain

October 26, 2007

Analysis of:U.S. veterans dept to limit Glaxo's Avandia: report | www.reuters.com

Another large provider votes thumbs-down on Avandia.Actos remains innocent until proven guilty.

Advicor-the forgotten combination

January 31, 2007

Analysis of:Torcetrapib tanks, but there is still a future in HDL cholesterol-raising therapies | www.theheart.org

1. There are no new drugs designed to raise HDL anywhere close to coming to market

2. Niacin remains the best agent on the market (in terms of HDL raising and improved outcomes) and is undergoing some potential improvement to reduce annoying side effects

3. There remains great debate as to what the biological mechanisms are of a particular therapeutic agent vs. how that will translate into "bottom line" clinical outcomes.

Potential Advantages of Prasugrel

November 21, 2006

Analysis of:New Study Shows Prasugrel Achieves Faster Onset and Higher Levels of Platelet Inhibition than Clopidogrel at Approved or Higher Doses | newsroom.lilly.com

Prasugrel in early studies appears to show advantages over Clopidogrel (Plavix) that could make it the preferred adjunctive agent in the setting of percutaneous coronary interventions (stent placements) and acute coronary syndromes.

Effective anti-platelet agents are critical to the overall success of PCI (stent placement) and long-term outcomes after acute coronary syndrome.

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