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 .
LDL-C goal attainment with the addition of ezetimibe to on-going simvastatin treatment in coronary heart disease patients with hypercholesterolemia
ABSTRACT Objective : To evaluate the addition of ezetimibe or placebo to on-going simvastatin treatment on attaining the LDL‐C treatment target of ≤ 2.60 mmol/L ( 100 mg/dL ) in coronary heart disease ( CHD ) patients with hypercholesterolemia . Methods : Patients with documented CHD were recruited if they were on a stable dose of simvastatin 10 mg or 20 mg for at least 6 weeks , had LDL‐C > 2.60 mmol/L and ≤ 4.20 mmol/L ( > 100 mg/dL and ≤ 160 mg/dL ) , triglycerides ≤ 4.00 mmol/L ( 355 mg/dL ) and hepatic transaminases and creatine kinase ≤ 50 % above the upper limit of normal . After a 4-week placebo and diet run-in period , eligible patients were r and omized to a double-blind , placebo-controlled comparative study with ezetimibe 10 mg co-administered with on-going simvastatin 10 mg or 20 mg ( n = 208 )  versus placebo to match ezetimibe co-administered with simvastatin 10 mg or 20 mg for 6 weeks ( n = 210 ) . Results : When ezetimibe was added to on-going simvastatin therapy , a significantly greater percentage of patients attained the LDL‐C target of ≤ 2.60 mmol/L after 6 weeks of treatment compared to placebo added to on-going simvastatin ( 80.4 % vs. 17.4 % , respectively ; p ≤ 0.001 ) . When co-administered with on-going simvastatin  therapy , mean percentage reduction in LDL‐C from baseline was significantly larger in the ezetimibe group compared to placebo ( 27.1 % vs. 4.1 % , respectively ; p ≤ 0.001 ) . The co-administration of ezetimibe or placebo to on-going simvastatin treatment was generally well tolerated . Conclusions : Ezetimibe co-administered with on-going simvastatin 10 mg or 20 mg treatment enabled more CHD patients with hypercholesterolemia to attain the LDL‐C treatment target of ≤ 2.60
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 .