All at sea: New lipid-lowering drug trials continue to disappoint

摘要

It is the end of the year and the traditional time to look back at developments and to try and assess their significance. From my house, I currently gaze out over a sea of water because of the flooding around the city in which I live. Flood and ebb also well describes the history of lipid trials. For a decade from 1995, lipid-lowering trials always offered something new and changed clinical practice in area after area in cardiovascular disease (CVD) therapeutics. These were the salad days of these medications and their proponents. Then in 2005, the first signs of therapeutic over-reach become discernible. Trials with fibrates delivered equivocal results (1) and surrogate outcome trials with ezetimibe (2) failed to deliver the expected benefits. As the years progressed, further definitively negative trials appeared in the field of chronic renal disease (3) and chronic cardiac failure (4,5).