A large study of a new type of cholesterol medicine from Merck & Co Inc. found it cut the risk of heart attack and death by a modest 9 percent, while causing a build up of the drug in fat tissue, leaving its commercial future uncertain.

Researchers, who presented the findings to a medical congress in Barcelona on Tuesday, concluded anacetrapib's efficacy could be due to its affect on bad LDL cholesterol, rather than any more novel action.

Merck said it had not decided whether to seek regulatory approval for the treatment -- part of a class known as CETP inhibitors designed to raise HDL, the so-called good cholesterol.

The company announced in June that the study met its main goal, but details have only now been disclosed. It had also previously said that prolonged use of the drug caused accumulation in fat, which may or may not be a problem.

Bernstein analyst Tim Anderson believes it is now unlikely Merck will decide to file anacetrapib for approval, while Berenberg's Alistair Campbell described the results as lackluster.

"It is difficult to see overwhelming physician enthusiasm for anacetrapib," Campbell said.

A little over a decade ago, CETP inhibitors were hailed as the next big heart drug but companies including Pfizer Inc., Eli Lilly and Roche eventually scrapped development programs amid lack of efficacy or safety issues.

Since then, drugmakers have gone on to develop and commercialize another class of cholesterol drugs called PCSK9s.

Merck presented results from its 4-year trial of about 30,000 high-risk heart patients already on statin drugs at the European Society of Cardiology Congress. Statin drugs lower levels of LDL cholesterol.

The study, also published in the New England Journal of Medicine, found that adding anacetrapib to a statin reduced the combined risk of heart attack, heart-related death and need for repeat artery-clearing procedures to 10.8 percent, compared with 11.8 percent for patients on a placebo and a statin.

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