Critique of Ivor's IMPROVE-IT article

Ivor makes a common mistake in asking for decrease in mortality results.  If Zetia was tested with placebo as a control, there would have been a significant drop in mortality.  IMPROVE-IT was started at baseline LDLc at 94.  The control arm was a statin which is already known to decrease mortality.

Ivor writes:

"But not a single life saved.
Not even 1 out of 18,000 very sick people in a seven year timespan.
How utterly.......underwhelming."

Ivor makes a common mistake in asking
for decrease in mortality results.
 If Zetia was tested with placebo as a control,
there would have been a significant drop in mortality.  
IMPROVE-IT was started at baseline LDLc at 94.
The control arm was a statin
which is already known to decrease mortality.

4S trial Simvastatin vs Placebo with LDLc 188 link

Primary Outcome

All-cause mortality

11.5% vs. 8.2% (RR 0.70; 95% CI 0.58-0.85; P=0.0003; NNT 30)

For IMPROVE-TRAIL to get improved mortality from baseline LDLc 94
is not likely and does not disqualify  Zetia

The important point is that adding Zetia to a statin the LDLc was lower than a statin alone.  It took 7 years to tease out a statistically significant difference but it occurred.

To see my detailed review of Ivor's article go to my

 review  link easy to read