Torcetrapib, a new medication developed by Pfizer, is very effective in increasing HDL levels ("good" cholesterol). There is a huge marketing niche for such medications since currently we lack a very efective pharmacological therapy for low HDL, apart from Niacin. The first hint of trouble for torcetrapib was the preliminary report that the drug increases blood pressure. The latest results from a trial of about 15000 patients show significantly increased mortality in the group treated with torcetrapib (7500 patients). According to a Pfizer spokesman, 82 patients taking the combination of torcetrapib and Lipitor died, compared to 51 deaths in the arm of the study where patients were taking Lipitor alone.
Pfizer announced today that it will stop future development of the new drug. The company spent around $800 million to develop torcetrapib and the share prices will certainly take a big hit tomorrow. Ultimately though, there is no doubt that Pfizer did the right thing by reporting the disappointing results early.
We are back to square one -- there is no highly effective pharmacological treatment for low HDL apart from Niacin which usefulness is limited by unpleasant side effects (flushing) and poor glucose control in diabetic patients. Fibrates can also be used to raise HDL levels.
Further reading: A 33-year-old man has a low HDL level. Should you treat him?
Pfizer cuts off cholesterol drug trials. USA Today.
Pfizer's Torcetrapib: Rest In Peace. Dr. Wes.
Deaths Halt Development Of Pfizer Cholesterol Drug. WSJ.
Effects of Torcetrapib in Patients at High Risk for Coronary Events. NEJM, Volume 357:2109-2122, November 22, 2007.