Cholesterol Remains a Sticky Foe

It was a bad week for good cholesterol.

Test results on several experimental products were released at a recent cardiology conference, and a number of the drugs were ineffective or disappointing.

That means companies such as Pfizer(PFE Quote), Eli Lilly(LLY Quote) and AstraZeneca(AZN Quote) have to decide if they want to spend hundreds of millions of more dollars on new tests.

The stakes are high, but so are the potential rewards. Companies are looking for additional ways to prevent heart disease caused by plaque-clogged arteries. A standard of care is the class of drugs known as statins -- Pfizer's Lipitor and AstraZeneca's Crestor among them -- that reduce low-density lipoprotein, or LDL, the so-called bad cholesterol.

The logical new-drug target is good cholesterol, or high-density lipoprotein. However, raising HDL isn't easy, and the handful of marketed HDL drugs offer modest gains or present unpleasant side effects that hamper their sales.

As doctors, drugmakers and investors learned from the American College of Cardiology meeting March 24 through 27, new effective and safe HDL medications are elusive targets.

For Pfizer, the answer regarding torcetrapib was clear. The disappointing results of a new study, released March 26, simply provided a footnote to the company's December decision to cancel the drug.

Torcetrapib did a great job of raising HDL, but the latest test findings show that the compound plus Lipitor didn't do any better than Lipitor alone in reducing arterial plaque.