Dear Docs and friends of Science,

Drugs Intensive therapy with statin drugs may not just stall deterioration of
the arteries but actually reverse it, research suggests.
http://news.bbc.co.uk/1/hi/health/4800772.stm


The build-up of fatty deposits inside the arteries - atherosclerosis - can
trigger cardiovascular disease. An international study of 349 patients over two
years found high doses of a powerful new statin, rosuvastatin, could break down
the deposits. Details were presented to an American College of Cardiology
meeting. Cardiovascular disease kills 233,000 people a year in the UK, and an
estimated 16.7 million a year world-wide. The fatty deposits inside arteries
can trigger problems by breaking off and blocking blood flow. Dr Sarah Jarvis,
a London GP and member of the Royal College of General Practitioners, described
the results as "dramatically exciting". She said: "We have a drug that can not
only halt the progression of the disease but, in the vast majority of patients,
it actually showed the disease regress." Professor Peter Weissberg, medical
director of the British Heart Foundation, said the study was "important". But
he said it was yet to be demonstrated that breaking down the fatty deposits
would actually mean fewer heart attacks.

Bad cholesterol

The study focused on patients with cardiovascular disease at centres in the US,
Canada, Europe and Australia. They were given intensive treatment with
rosuvastatin, known commercially as Crestor, which, along with other statins,
was known to cut cholesterol levels. Patients received at least one 40mg pill of
the drug a day - most statins are more commonly used in doses of 10mg or
20mg/day. Tests found that the drug cut levels of potentially damaging
LDL-cholesterol by about 50% and boosted levels of the beneficial HDL form by
around 15%. As harmful cholesterol was reduced, build-ups of fatty deposits in
the patients' arteries also showed signs of a reduction.

After two years of treatment their thickness was reduced by 6.8% - and even more
so in particularly diseased parts of a blood vessel. The research found almost
four out of five patients (78%) demonstrated some reduction in the level of
atherosclerosis. The reductions were found to be greatest in the arteries with
the most severe disease. Professor Weissberg said: "Previously it was thought
that statins saved lives by stabilising plaques - the build-up of fatty deposits
in the arteries - thereby preventing them from rupturing to cause a heart attack
or stroke. "This study encouragingly seems to demonstrate a small but definite
regression of atherosclerotic plaques. "However, this study wasn't designed to
test whether this treatment actually saves lives, so whilst the results sound
promising and are likely to translate into a better outcome for heart patients,
we still need further studies to confirm whether the regression demonstrated
translates to fewer heart attacks."

Safety concern

Rosuvastatin has previously been linked to a small number of cases of a muscle
wasting disease. However, the drug was given a clean bill of health by the US
Food and Drug Administration last year. A British Heart Foundation spokesman
said statins were extremely safe drugs. However, he said it might not be
practical - or economically viable - to put large numbers of patients on a high
dose of one of the most potent forms of the drug. Side effects are more likely
at higher doses of drug. Rosemary Leonard, a London GP and medical broadcaster,
said: "These researchers used an incredibly high dose of a statin drug. "There
have been warnings about using this high a dose, and GPs certainly don't start
with this high a dose." The study, which was funded by AstraZeneca, the makers
of rosuvastatin, will be published in the Journal of the American Medical
Association in April.



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