Similar trends were observed for changes in total cholesterol .
Implication sGiven the available data , the addition of ezetimibe to ongoing simvastatin , atorvastatin , or rosuvastatin monotherapy offers greater reduction in LDL-C among patients at high risk of CVD compared to doubling the initial statin dose
Purpose While statins are used as first-line treatments for high-risk patients with hypercholesterolemia , statin monotherapy is often insufficient to achieve target low-density lipoprotein cholesterol ( LDL-C ) levels .
Second-line treatment options include up-titration of statin dose , switching to a more potent statin , or combination therapy , e.g. , with ezetimibe .
The aim of this study was to evaluate the efficacy of adding ezetimibe to simvastatin , atorvastatin , or rosuvastatin monotherapy versus doubling the dosage or switching to a higher-potency statin in a population of patients with hypocholesterolemia at high risk of cardiovascular disease ( CVD ) and who had been previously treated with a statin .
Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II.
BACKGROUND National Cholesterol Education Program Adult Treatment Panel III guidelines for patients at a high risk of coronary heart disease set a low-density lipoprotein cholesterol ( LDL-C ) target of < 100 mg/dL. This target can be difficult to attain with diet and current therapy . METHODS In a 16-week multinational trial , 1993 high-risk patients were r and omized to rosuvastatin 20 mg , atorvastatin 10 mg , atorvastatin 20 mg , simvastatin 20 mg , or simvastatin 40 mg for 8 weeks . Patients either remained on starting treatment or switched to lower or milligram-equivalent doses of rosuvastatin for 8 more weeks . RESULTS At 16 weeks , more patients achieved their LDL-C target by switching to rosuvastatin 10 mg than staying on atorvastatin 10 mg ( 66 % vs 42 % , P < .001 ) or simvastatin 20 mg ( 73 % vs 32 % , P < .001 ) . Changing to rosuvastatin 20 mg brought more patients to their LDL-C target than staying on atorvastatin 20 mg ( 79 % vs 64 % , P < .001 ) or simvastatin 40 mg ( 84 % vs 56 % , P < .001 ) . More very high risk patients achieved an LDL-C target of < 70 mg/dL when changed to rosuvastatin from atorvastatin or simvastatin ( within-arm comparisons P < .01 ) . More hypertriglyceridemic patients ( triglycerides > or = 200 mg/dL ) met LDL-C , non-high-density lipoprotein cholesterol ( non-HDL-C ) , and apolipoprotein B targets by changing to rosuvastatin . Switching to rosuvastatin produced greater reductions in LDL-C , total cholesterol , non-HDL-C , apolipoprotein B , and lipid ratios . All treatments were well tolerated , with no differences among treatment groups in skeletal muscle , hepatic , or renal toxicity . CONCLUSION Rosuvastatin 10 or 20 mg is an effective and safe therapeutic option for high-risk patients to achieve their lipid and apolipoprotein targets
Similar trends were observed for changes in total cholesterol .
Implication sGiven the available data , the addition of ezetimibe to ongoing simvastatin , atorvastatin , or rosuvastatin monotherapy offers greater reduction in LDL-C among patients at high risk of CVD compared to doubling the initial statin dose
Purpose While statins are used as first-line treatments for high-risk patients with hypercholesterolemia , statin monotherapy is often insufficient to achieve target low-density lipoprotein cholesterol ( LDL-C ) levels .
Second-line treatment options include up-titration of statin dose , switching to a more potent statin , or combination therapy , e.g. , with ezetimibe .
The aim of this study was to evaluate the efficacy of adding ezetimibe to simvastatin , atorvastatin , or rosuvastatin monotherapy versus doubling the dosage or switching to a higher-potency statin in a population of patients with hypocholesterolemia at high risk of cardiovascular disease ( CVD ) and who had been previously treated with a statin .