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 .
Effect of ezetimibe coadministration with simvastatin in a Middle Eastern population: a prospective, multicentre, randomized, double-blind, placebo-controlled trial
Objectives To assess the efficacy and safety of ezetimibe coadministered with simvastatin in patients with primary hypercholesterolaemia and coronary artery disease ( CAD ) . Design and setting Prospect i ve , multicentre , r and omized , double-blind , placebo-controlled trial conducted in three Middle Eastern countries . Patients Patients with known CAD , who were being treated with simvastatin 20 mg and had low-density lipoprotein cholesterol ( LDL-C ) concentrations of 2.6 to 4.1 mmol/l , were r and omized to receive daily coadministration of  ezetimibe 10 mg  or placebo . Main outcome measures The primary outcome was percentage reduction of LDL-C after 6 weeks of r and omization . Secondary endpoints included number of patients who achieved National Cholesterol Education Program Adult Treatment Panel III ( NCEP ATP III ) LDL-C level and safety and tolerability . Results We enrolled 144 patients of whom 120 had blood available for final analysis . The coadministration of ezetimibe with ongoing simvastatin therapy result ed in a statistically significant additional reduction in LDL-C concentration as compared with simvastatin monotherapy ( −26.7 versus −9.1 % , respectively ; total additional reduction of 17.6 % , P < 0.0001 ) . More patients in the ezetimibe and simvastatin group achieved NCEP ATP III LDL-C target levels than in the simvastatin monotherapy group ( 70 versus 33 % , respectively ; P = 0.0001 ) . The coadministration of ezetimibe with simvastatin was well tolerated with a safety profile similar to that of simvastatin monotherapy . Conclusion When coadministered with simvastatin therapy , ezetimibe result ed in significant additional reduction in LDL-C and enabled more patients to achieve NCEP ATP III LDL-C target levels . This was achieved safely and with excellent tolerability
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 .