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According to AstraZeneca,
only one-third of US patients who are eligible for cholesterol-reducing
treatment receive drug therapy. The European Atherosclerosis
Society (EAS) considers desirable values of total cholesterol
to be no more than 5.2mmol/l, and recommend commencing drug
treatment for levels above 6.5mmol/l, if a trial diet has
been unsuccessful.
IMS Health's Pharmacast
& Beyond advocate that the rapid growth in the cholesterol
and triglyceride reducer market will be as a result not
only of more aggressive use of lipid-lowering therapy, but
also an increase in the proportion of patients diagnosed
with high levels of cholesterol, due to better screening
techniques.
Drug Treatment of Hypercholesterolemia
Treatment of hypercholesterolemia involves five main groups
of drugs:
- Statins (HMG-CoA reductase inhibitors)
- Bile Acid Sequestrants
- Fibrates
- Nicotinic Acid Derivatives
- Marine Triglycerides
Statins, such as Lipitor,
Zocor and Pravachol act by blocking the endogenous synthesis
of cholesterol through the competitive inhibition of the
rate-limiting enzyme responsible for the hepatic synthesis
of cholesterol.
Statins reduce low-density lipoprotein (LDL) cholesterol
by up to 40% and in addition, they can moderately reduce
plasma triglycerides. Bayer hopes to maintain and grow the
market share of its agent, Baycol/Lipobay (cerivastatin),
by filing an 800 microgram dosage version, which promises
to deliver competitive LDL lowering.
In 1999, according to IMS Health's C10A Therapy Area Sales
Report, statin drugs accounted for 87.9% of the cholesterol
and triglyceride market, up from the 1998 figure of 87.1%.
Implications of Increased Cholesterol
Levels
High cholesterol levels are one of the factors implicated
in coronary heart disease (CHD). Elevated levels of cholesterol,
in particular LDL, are associated with an increased risk
for both fatal and non-fatal heart attacks.
Reducing cholesterol levels with diet, exercise and drugs
has been shown to slow (and even reverse) the progression
of atherosclerosis and to reduce the risk of myocardial
infarction. After five years, a 10% reduction in LDL-C results
in a decrease in CHD of up to 50%.
16 March 2000, Copyright IMS HEALTH
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