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 .
Efficacy and safety of ezetimibe added on to atorvastatin (40 mg) compared with uptitration of atorvastatin (to 80 mg) in hypercholesterolemic patients at high risk of coronary heart disease.
The percentage of change from baseline in low-density lipoprotein ( LDL ) cholesterol after the addition of ezetimibe 10 mg to atorvastatin 40 mg was compared with uptitration to atorvastatin 80 mg . In this multicenter , double-blind , parallel-group study , adult hypercholesterolemic patients using atorvastatin 40 mg/day were r and omly assigned to atorvastatin 40 mg plus ezetimibe 10 mg or uptitration to atorvastatin 80 mg . After 6 weeks of treatment , compared with atorvastatin 80 mg , atorvastatin 40 mg plus ezetimibe significantly reduced the primary end point of LDL cholesterol by -27 % versus atorvastatin 80 mg by -11 % ( p < 0.001 ) , as well as significantly reduced non-high-density lipoprotein cholesterol , apolipoprotein B , total cholesterol , and triglycerides significantly more than atorvastatin 80 mg ( all p < 0.001 ) . Percentages of change in high-sensitivity C-reactive protein , high-density lipoprotein cholesterol , and apolipoprotein A-I were similar between groups . Significantly more patients treated with atorvastatin 40 mg plus ezetimibe reached LDL cholesterol < 70 mg/dl versus patients treated with atorvastatin 80 mg ( 74 % vs 32 % ; p < 0.001 ) . Safety and tolerability profiles and incidence of liver and muscle adverse experiences were generally similar between groups . In conclusion , these results showed that adding ezetimibe to atorvastatin 40 mg was significantly more effective than uptitrating to atorvastatin 80 mg at lowering LDL cholesterol and other lipid parameters . Both treatments were generally well tolerated ( clinical trial no. NCT00276484 )
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 .