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Pactimibe Doesn't Help, May Hurt in Atherosclerosis

First trial of drug in promising new class delivers disappointing results

FRIDAY, Nov. 18 (HealthDay News) -- ACAT inhibitors are a promising new class of drugs that have been shown to slow atherosclerosis in mice, but the first trial of one such drug, pactimibe, has been a disappointment, according to results from the ACTIVATE (ACAT Intravascular Atherosclerosis Treatment Evaluation) study presented this week at the American Heart Association's scientific sessions in Dallas.

The drug failed to prevent the progression of atherosclerosis, and may have even promoted atherosclerosis, said Steven Nissen, M.D., of The Cleveland Clinic in Ohio.

Nissen and colleagues randomized 534 patients with symptomatic coronary artery disease and greater than 20% stenosis to treatment with either pactimibe or a placebo. Intravascular ultrasound was used to assess coronary arteries at baseline and at 18 months.

Pactimibe did not slow the progression of atherosclerosis, as measured by the percent atheroma volume, and in some cases seemed to promote atherosclerosis. The study was not powered to determine clinical outcomes. The trial was funded by Sankyo Co., but Nissen noted that he does not accept money from drug companies.

"I don't think it kills the class but it is very discouraging for this class moving forward," said Nissen.

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