by Dr. John Briffa
The Cholesterol Truth


Ezetimibe is a cholesterol-reducing drug. Unlike statins (which reduce cholesterol production in the liver), ezetimibe blocks the absorption of cholesterol from the gut. It’s generally very effective at reducing cholesterol levels. On this basis, the Food and Drugs Administration (FDA) licensed ezetimibe for use in the treatment of raised cholesterol in 2002. It’s been quite a bestseller too, racking up sales in the order of $4 billion dollars annually.

However, there is a dark underbelly to the rip-roaring success of ezetimibe. While it’s effective at reducing cholesterol, to date no study has found that it helps reduce truly important things like the risk of heart attack and death. In fact, there is some evidence that it might do more harm than good. For example, 2008 saw the publication of the so-called ENHANCE study which found that adding ezetimibe to simvastatin (a statin) led to an increase in the thickness of artery walls in the neck compared to simvastatin alone (though the difference was not statistically significant). So underwhelming (or concerning) were these results to the manufacturer, that they were kept under wraps for 2 years before the US government forced their publication.

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by Uffe Ravnskov, MD, PhD

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