Wednesday, September 3, 2008

"Ezetimibe and Cancer — An Uncertain Association"

The New England Journal of Medicine (NEJM) editorial article published September 2, 2008 bears the title "Ezetimibe and Cancer — An Uncertain Association". You might ask 'what the heck is Ezetimibe?' It is another one of those drugs used to lower serum cholesterol levels frequently in conjunction or parallel with a statin drug. Of late it has actually been combined into the same pill with Simvastatin also known as Zocor and the combination called Vytorin.

Also in the above mentioned issue of NEJM they published the results of the SEAS trial (Simvastatin and Ezetimibe in Aortic Stenosis). "In the trial, a combination of simvastatin and ezetimibe (Vytorin) was compared with placebo with respect to the incidence of cardiovascular events in older people with aortic-valve stenosis. The treatment had no impact on the progression of aortic stenosis or on cardiovascular clinical events in general, ..."

Now note the following from the NEJM editorial....

"There was, however, an unexpected finding in the trial. An excess of incident cancers was observed in the simvastatin–ezetimibe group, with 105 in that group as compared with 70 in the placebo group (P=0.01). There was an increase in the incidence of a variety of cancers, including prostate, gastrointestinal, and skin cancers. Also, deaths from cancer were more frequent in the active-treatment group (39 deaths, vs. 23 in the placebo group), ..."


Finally the editorial says ...

"Ezetimibe interferes with the gastrointestinal absorption not only of cholesterol, but also of other molecular entities that could conceivably affect the growth of cancer cells. The fact that the combined data from all three trials showed an increase in cancer mortality with ezetimibe should not be assumed to be a chance finding until further data are in. It is appropriate that SHARP and IMPROVE-IT continue. Careful follow-up of the patients in these trials will be essential, and other existing data sets on ezetimibe-treated patients should be analyzed for cancer end points. The Food and Drug Administration has already announced that during the next few months it will conduct its own analysis of the potential cancer hazard of ezetimibe."

Note: In the above quotes from the NEJM editorial the 'bolded' text was emphasis added my me and did not occur in the original article which you can read in its entirety here. You can also read results of the (SEAS) trial here.

See also this Natural News article on the same subject.

Now a bit of personal history as related to the above information and also cited in this blog over one year ago ( see it here).

  • I was on cholesterol lowering statins for roughly 20 years beginning in the mid 1980s.
  • In 1994 (with low cholesterol) I had a heart attack resulting in open heart surgery.
  • P.S. Four subsequent heart attacks (most recent June 2006), three requiring stents - all while having well below 'their recommended' serum cholesterol readings. (added this item Oct 8, 2007)
  • In 2003 I had a fist sized gastrointestinal cancerous tumor removed along with about 9 inches of my small intestine.
  • I've had one basal cell carcinoma (skin cancer) surgically removed about 3 years ago.
  • I personally have no data to tie these events in my life together. (I might change this statement as this connection is further explored)
  • I feel good now - like none of the above had happened. It almost seems surreal. But I've had four subsequent heart attacks - three with stents and there is some possibility that the cancer could reappear.

And a piece of info not included in the above is that for a significant length of time while taking statin drugs to lower my cholesterol and thus presumable reduce chances of heart attack, I was also taking Ezetimbe. All that before the gastrointestional cancer and basal cell carcinoma (skin cancer) were discovered and treated seemingly successfully.

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