Drug companies are attempting to come up with a drug that raises HDL cholesterol levels. Will torcetrapid be the first? If torcetrapid is approved for this purpose, will it have more benefits than side effects? Much remains to be still learned about torceptrapid. Let's keep in mind that sometimes a side effect of a medicine can be worse than the disease. Statins are known to cause myopathy. Will torcetrapid have a serious side effect that will be found out after approval?
2006 - Pfizer cut off torcetrapib's trial because of "an imbalance of mortality and cardiovascular events" associated with its use.
July 2006 - Pfizer says that it will apply for approval to sell a promising new heart treatment as a standalone pill — rather than only in combination with Lipitor, Pfizer’s best-selling cholesterol treatment. The new drug, torcetrapib, is still being tested in clinical trials and is at least 18 months from federal approval. But some cardiologists say it has the potential to become a new treatment for heart disease. Clinical trials show that torcetrapib raises the levels of so-called good cholesterol, a novel approach to preventing heart attacks and strokes. Previously, Pfizer had said it would sell torcetrapib only in combination with Lipitor, one of several medicines called statins that lower levels of LDL, or bad cholesterol. Cholesterol-reducing medicines are the largest prescription drug category, with worldwide sales of $32 billion last year. By offering torcetrapib only in a combination pill, Pfizer would have forced patients taking other statins — like Zocor, from Merck — to switch to Lipitor if they wanted torcetrapib’s benefits. In an interview last year, Dr. John L. LaMattina, Pfizer’s top scientist, defended the company’s plans, saying that the costs of testing torcetrapib alongside every statin would be prohibitive. Already, Pfizer says it is spending $800 million to develop torcetrapib. Pfizer is the world’s largest drug maker, with sales of $51 billion and a profit of $8 billion last year.
Torcetrapid Research
Effects of an Inhibitor of Cholesteryl Ester Transfer Protein on HDL Cholesterol
NEJM, 2004.
Margaret E. Brousseau, Ph.D., Ernst J. Schaefer, M.D.. Wolfe, B.S., LeAnne T. Bloedon, M.S., R.D., Andres G. Digenio,
M.D., Ph.D., Ronald W. Clark, M.S., James P. Mancuso, Ph.D., and Daniel J.
Rader, M.D. From the Lipid Research Laboratory, Division of Endocrinology,
Metabolism, Diabetes, and Molecular Medicine, New England Medical Center and
Tufts University School of Medicine, Boston; the Department of Medicine and
Center for Experimental Therapeutics, University of Pennsylvania School of
Medicine, Philadelphia; and the Departments of Cardiovascular and Metabolic
Diseases and Clinical Biostatistics (J.P.M.), Pfizer, Groton, Conn.
Decreased high-density lipoprotein (HDL) cholesterol levels constitute a major
risk factor for coronary heart disease; however, there are no therapies that
substantially raise HDL cholesterol levels. Inhibition of cholesteryl ester
transfer protein (CETP) has been proposed as a strategy to raise HDL cholesterol
levels. We conducted a single-blind, placebo-controlled study to examine the
effects of torcetrapib, a potent inhibitor of CETP, on plasma lipoprotein levels
in 19 subjects with low levels of HDL cholesterol (<40 mg per deciliter), 9 of
whom were also treated with 20 mg of atorvastatin daily. All the subjects
received placebo for four weeks and then received 120 mg of torcetrapib daily
for the following four weeks. Six of the subjects who did not receive
atorvastatin also participated in a third phase, in which they received 120 mg
of torcetrapib twice daily for four weeks. Results: Treatment with 120 mg of
torcetrapib daily increased plasma concentrations of HDL cholesterol by 61
percent (P<0.001) and 46 percent in the atorvastatin and non-atorvastatin
cohorts, respectively, and treatment with 120 mg twice daily increased HDL
cholesterol by 106 percent. Torcetrapib also reduced low-density lipoprotein (LDL)
cholesterol levels by 17 percent in the atorvastatin cohort (P=0.02). Finally,
torcetrapib significantly altered the distribution of cholesterol among HDL and
LDL subclasses, resulting in increases in the mean particle size of HDL and LDL
in each cohort. Conclusions: In subjects with low HDL cholesterol levels, CETP
inhibition with torcetrapib markedly increased HDL cholesterol levels and also
decreased LDL cholesterol levels, both when administered as monotherapy and when
administered in combination with a statin.