Can Torcetrapib Be Retooled?

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  • 12/07/2006
Two great articles about Pfizer's drug torcetrapib. One in the Wall Street Journal the describes the inner workings of the Drug Safety Board -- capturing both the integrity of the scientists who led it and statistical methods that are applied to determine drug safety.

The other is in assessing whether the problem with torcetrapib is rooted in the way the drug itself elevates LDL or the fact that as Moti Kashyap, who directs atherosclerosis research at the VA Medical Center in Long Beach, California points out "When HDLs excrete cholesterol in the liver, they actually rely on LDLs for part of this process. So inhibiting CETP, which prevents the transfer of cholesterol from HDL to LDL, might actually cause an abnormal and irreversible accumulation of cholesterol in the body. "You're blocking a physiologic mechanism to eliminate cholesterol and effectively constipating the pathway," says Kashyap.

These articles are well-written, well-researched, balanced and thoughtful. Taken together it raises an important question: wouldn't drug development be helped by developing models that incorporate the off-target effects of medicines earlier in the clinical testing process? And that raises another question. Given the small difference in mortality is it possible to target the drug to people based on genotype variation? Can torcetrapib be retooled?

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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