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"Vytorin has struck out again, this time in a clinical trial that compared the drug's safety and efficacy to a prescription form of the B vitamin niacin. The results of the trial, which the New England Journal of Medicine featured in an article and two editorials, were presented Sunday at an American Heart Association meeting and showed that in a direct comparison, niacin worked significantly better than Vytorin and Zetia in reducing arterial blockages. According to a report in NPR, "This study is the third to question whether ezetimibe drugs do what they're supposed to." If lowering LDL or "bad" cholesterol is the doctor's sole intention when prescribing Vytorin to patients, then the drug does a great job. However, as previous studies have shown, lower levels of LDL cholesterol don't automatically translate to cleaner arteries and lower incidences of cardiac arrest. While Vytorin worked better than statins combined with time-release Niacin to lower LDL cholesterol in 200 patients, its performance was inferior in reducing artery clogging deposits."

"Want more of that good HDL cholesterol? Try a timed-release niacin, and be skeptical if your doctor gives the sales pitch for Zetia or Vytorin. The authority for this is a study dubbed ARBITER-6, which was stopped suddenly this summer, with the study's authors insisting safety had nothing to do with it. It was a question of efficacy. The results, described in the New England Journal of Medicine, make clear that niacin does better at the main job, keeping arteries open"

Extended-release niacin or ezetimibe and carotid intima-media thickness. Taylor AJ, Villines TC, Stanek EJ, Devine PJ, Griffen L, Miller M, Weissman NJ, Turco M. N Engl J Med. 2009 Nov 26;361(22):2113-22. Epub 2009 Nov 15. PMID: 19915217 Conclusions This comparative-effectiveness trial shows that the use of extended-release niacin causes a significant regression of carotid intima-media thickness when combined with a statin and that niacin is superior to ezetimibe. (ClinicalTrials.gov number, NCT00397657 [ClinicalTrials.gov] .