Talk:Ezetimibe

Can

Can someone please check the side effects occurence? It's using the symbol "≥" 1%, saying that side effects occur in more than or (at minimum) 1% of patients. This seems to be a typo to me, and probably intends to say "≤ 1%". But I don't have actual knowledge, so if someone with accurate numbers can check and fix it if needed, that'd be fab.—Preceding unsigned comment added by Bugsi (talk • contribs) 04:30, 15 March 2007

It says "common side effects" which I believe would mean more than or at minimum 1% of patients; if it were less than 1% then it wouldn't fall under common. I do think if anyone comes across reliable numbers on each of the side-effects to get their actual incidence that would be preferable, though. Ryan Pedigo (talk) 20:03, 3 April 2010 (UTC)

Bad Science

interesting article by ben goldacre in the guardian here[1], or repeated in goldacre's blog, with comments, here[2], which someone might want to incorporate. goldacre's articles tend to be quite polemical and wouldn't be my first choice for a citation though--Mongreilf (talk) 17:09, 5 January 2008 (UTC)

thanks guys--Mongreilf (talk) 16:43, 15 January 2008 (UTC)

Growth of plaques

The article says that that Zetia was intended to reduce the growth of plaques, but it resulted in the growth of plaques less than the placebo. Doesn't that mean it DID actually reduce the growth of plaques? If something reduces the growth of children, it doesn't mean the children get smaller, only that they are smaller compared to what they would have been, i.e. less growth. Mauvila (talk) 08:34, 8 June 2008 (UTC)

ARBITER-6

It's been a couple of months since ARBITER-6 was terminated due to the results of a 'prespecified, blinded interim analysis'.[3] This essentially means that ezetimibe is clearly better than, or worse than, niacin. I'll keep my personal opinion on that out of this discussion, but this will be very interesting to add to the article once the results become available in the NEJM or wherever they end up publishing. Antelan 21:31, 5 October 2009 (UTC)

Looks like it's hard to make any conclusion. However, ARBITER-6 should be addressed in this article. I see that someone added it but was reverted for plagiarism. Antelan 18:28, 20 November 2009 (UTC)

LDL is neither "bad" nor cholesterol

"achieve their LDL (or bad cholesterol) targets" <- If the "bad cholesterol" bit absolutely MUST be included, it should be with quotation marks or preceded by "so-called".Bstard12 (talk) 06:33, 18 August 2013 (UTC)

New Finding

There are news reports now that the trial showed positive outcomes for this drug such as [4]. So the article page shold be updated. Jerryfern (talk) 22:15, 17 November 2014 (UTC)

actually, we do not add content to Wikipedia about hot clinical news. We wait until there is a review article published in the biomedical literature that puts the clinical trial in context. please see WP:MEDRS]. Jytdog (talk) 22:47, 17 November 2014 (UTC)

We now have a article that is out out date, badly so. It lacks information even a casual watcher of the evening news is aware of, to say nothing of an explanation of the history of testing. User:Fred Bauder Talk 09:05, 18 November 2014 (UTC)

I have initiated a discussion at Wikipedia:Reliable_sources/Noticeboard#Six-year_study.2C_reported_at_the_annual_meeting_of_the_American_Heart_Association User:Fred Bauder Talk 09:32, 18 November 2014 (UTC)

note: after Fred opened a second discussion at Wikipedia_talk:Identifying_reliable_sources_(medicine)#Six-year_study.2C_reported_at_the_annual_meeting_of_the_American_Heart_Association, an admin redirected the RSN discussion to the second discussion at WT:MEDRS. Jytdog (talk) 13:12, 18 November 2014 (UTC)

WP:MEDRS is very clear on this: "Scientific findings are often touted in the popular press as soon as the original, primary research report is released, and before the scientific community has had an opportunity to analyze the new results. Such sources should generally be entirely omitted (in accordance with recentism), because determining the weight to give to such a study requires reliable secondary sources (not press releases or newspaper articles based on them)." Jytdog (talk) 12:10, 18 November 2014 (UTC)

and generally, per WP:MEDMOS we don't drill deeply down into the nitty gritty. we simply present the current consensus, in plain english. which accords with WP:NOTJOURNAL. Jytdog (talk) 12:16, 18 November 2014 (UTC)

Here is an interesting note: "Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal." from MedPageToday http://www.medpagetoday.com/MeetingCoverage/AHA/48637?xid=nl_mpt_DHE_2014-11-18 User:Fred Bauder Talk

no WP:MEDRS describes what are reliable sources for health related content in Wikipedia. conference abstracts are less than WP:PRIMARY as they are not even peer-reviewed. Jytdog (talk) 13:12, 18 November 2014 (UTC)

AHA guidelines

This is an interesting statement: "The IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) results support guidelines presented at last year’s Scientific Sessions by the American Heart Association and American College of Cardiology." http://blog.heart.org/study-shows-cholesterol-combination-significantly-reduced-cardiovascular-risks/ User:Fred Bauder Talk 10:26, 18 November 2014 (UTC)

what are you suggesting we do with respect to the article? Jytdog (talk) 12:11, 18 November 2014 (UTC)

That, while being suitably cautious about medical information, we use reliable sources to report major announcements and controversies. I think medical events that are not medical in themselves require much less stringent vetting than information about the efficacy of a drug such as this and how it compares to other options. For example the funding of the study by its maker is interesting, as is its announcement at the AHA convention. User:Fred Bauder Talk 13:02, 18 November 2014 (UTC)

Guidelines for treatment in this instance are also interesting as the latest guideline recommend treatment with statins only. This seems to upset the apple cart. But are there differing AHA guidelines? User:Fred Bauder Talk 13:04, 18 November 2014 (UTC)

guideline-issuing authorities are not going to change anything based on results presented at a conference. they will wait til the study is actually published, read it, debate it, and in a few months they will probably update their guidelines, at least to include discussion of this trial (it may or may not change the actual treatment guideline which is what we care about). in the meantime, the medical community will also be waiting for the full study to be published, and will stew on it, and then the reviews will start to come. Those are the kind of WP:SECONDARY sources upon which we base health-related content in WP - statements by major medical and scientific bodies, and reviews published in the biomedical literature. Not popular media, not blogs, not conference abstracts, not even WP:PRIMARY sources in the research is first actually published in a peer-reviewed journal. Secondary sources. This is actually true of all of WP, as described in the policies WP:NPOV, WP:OR, and WP:VERIFY, and the guidelines WP:RS and the guideline for health related content, WP:MEDRS. Jytdog (talk) 13:18, 18 November 2014 (UTC)

Actually no, you are overdoing it. However with respect to medical fact, we cannot be too cautious. User:Fred Bauder Talk 14:58, 18 November 2014 (UTC)

clean up, clinical trials controversies section

I made a series of edits, each with its own edit note, to bring the article into line with MEDMOS and MEDRS. The article previously had a section on "Clinical trial controversy" as you can see in this old version. i had previously posted a question about what to do with the controversy section at WikiProject Medicine here. Thought about what people wrote there, and what the content of the "controversies" section actually was, and edited accordingly. Seems to me that the FDA approved the drug knowing full well that there was no mortality or CV morbidity data, and doctors knew that too, from day one. It is unclear to me what the "controversy" is or was; ambiguity is not controversy. There was definitely ambiguity in that nobody has known if the drug is actually driving good clinical outcomes or not. The article still communicates that. Jytdog (talk) 13:42, 18 November 2014 (UTC)

Ezetimibe to be available as a generic in 2016.

see: http://www.nytimes.com/2014/11/18/health/study-finds-alternative-to-statins-in-preventing-heart-attacks-and-strokes.html?_r=0 — Preceding unsigned comment added by Ocdcntx (talk • contribs) 02:03, 20 November 2014‎ (UTC)

see above. we will not discuss the clinical results until they are discussed in secondary source as described in WP:MEDRS (please do read it. NY Times nor any popular media is OK for health information). We'll discuss the generic thing when that happens.. Jytdog (talk) 02:43, 20 November 2014 (UTC)

Wise caution, e.g., "no differences were noted for all-cause mortality" http://www.cardiosource.org/science-and-quality/clinical-trials/i/improve-it.aspx?w_nav=RI

When we do get around to discussing the study, preliminary result including significant reduction in stroke and heart attacks were announced at a conference in mid November 2014.

References

Addition

Have moved this

"The IMPROVE-IT trial was a major trial intended to address the important question of whether further reductions in low-density lipoprotein cholesterol (LDL-C) achieved by adding ezetimibe to a statin drug would improve cardiovasacular outcomes. The study involved 18,444 patients who were at high risk of future cardiovascular events and had already stably recovered from an acute coronary syndrome event. While the results have not been published under peer review and have thus undergone only limited scientific scrutiny, the IMPROVE-IT investigators reported the final results of IMPROVE-IT at the American Heart Association Scientific Sessions 2014. The investigators report that adding ezetimibe to the statin drug simvastatin reduced LDL-C by an additional 15-mg/dL, relative risk of cardiovascular events by 6.4%, and relative risk of cardiovascular death, myocardial infarction (heart attack), or stroke by 10% relative to simvastatin alone; specifically, 34.7% of patients given simvastatin alone suffered a cardiovascular event, while only 32.7% of patients receiving ezetimibe/simvastatin combination therapy did."

Issues include

1. It reads like a press release
2. The study has not been published yet

Thus IMO we should wait. Doc James (talk · contribs · email) 00:19, 24 December 2014 (UTC)

As discussed above, yes we wait - not just until the study is published but even further, until there is a review that discusses the study results. Jytdog (talk) 02:11, 24 December 2014 (UTC)

Yes I do not image it will take too long unless there are issues. Doc James (talk · contribs · email) 02:50, 24 December 2014 (UTC)

References

History of ezetimibe

Wondering why there's no history for ezetimibe (like who/which company developed it). — Preceding unsigned comment added by 155.91.28.142 (talk) 20:34, 21 January 2021 (UTC)

Nonsensical statements

"Adding ezetimibe to statin treatment of high blood cholesterol has no effect on overall mortality or cardiovascular mortality, although it significantly reduces the risk of myocardial infarction and stroke. Combining ezetimibe with simvastatin had no effect on overall mortality but did lower the risk of heart attack or stroke in people with prior heart attack."

How is it possible to state "no effect on mortality" while claiming significant reduction of the risk of myocardial infraction, strike and heart attack? The risk reduction in death causing agents must have effect on mortality or there is no risk reduction. The two sentences quoted are either badly worded or illogical. They need to be corrected or altogether removed. Glebl1 (talk) 13:57, 16 September 2024 (UTC)