Merck pill may sharply lower cholesterol

Merck, the company that introduced statins to the world nearly 40 years ago, has a new, intensely powerful pill that can slash levels of dangerous LDL cholesterol to levels almost never seen in adults.

- GINA KOLATA

The new pill, enlicitide, blocks a liver protein, PCSK9, that slows the body's ability to clear cholesterol. With most PCSK9 blocked, LDL levels plummet and rates of heart attacks and strokes in high risk patients fall by up to 20% in just the first year.

At least 6 million adults in the United States are eligible for drugs that block PCSK 9.

Merck's head of research said the goal is to make the pill affordable. It would be an alternative to expensive biweekly or monthly injections of monoclonal antibodies that do the same thing. But only about 1% of eligible patients take the injections, which include Praluent by Regeneron and Sanofi, and Repatha by Amgen. Many patients don't want to inject themselves, and insurers put up obstacles to paying, cardiologists say.

The drugs' list prices are more than $500 a month.

On Saturday, at an American Heart Association meeting, Merck reported the results of a 24-week study of 2,912 people who had had a heart attack, stroke or other cardiovascular event, or were at risk for one. They were randomly assigned to take enlicitide, or a placebo. Those taking enlicitide reduced their LDL levels by up to 60%, the same amount as achieved by the injections.

There was no difference in side effects between those taking the pill and those taking a placebo.