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 .
Lipid-altering efficacy of switching from atorvastatin 10 mg/day to ezetimibe/simvastatin 10/20 mg/day compared to doubling the dose of atorvastatin in hypercholesterolaemic patients with atherosclerosis or coronary heart disease.
This r and omised , double-blind study evaluated the efficacy and safety of ezetimibe/simvastatin ( EZE/SIMVA ) 10/20 mg tablet compared to doubling the atorvastatin ( ATV ) dose in hypercholesterolaemic patients with atherosclerotic or coronary heart disease ( CHD ) . The study group included 435 male and female CHD patients ( aged > or=18 years ) who had not achieved their low-density lipoprotein cholesterol ( LDL-C ) goal of < 2.50 mmol/l while on a stable dose of ATV 10 mg for > or=6 weeks . After a 1-week diet/stabilisation period , patients with LDL-C > or=2.50 mmol/l and < or=4.20 mmol/l were r and omised ( 1:1 ) to EZE/SIMVA 10/20 mg/day ( n = 221 ) or ATV 20 mg/day ( n = 214 ) for 6 weeks . The primary efficacy objective was to determine the per cent reduction from baseline in LDL-C at week 6 . EZE/SIMVA 10/20 mg produced significantly greater mean per cent changes from baseline in LDL-C compared with ATV 20 mg ( -32.8 vs. -20.3 % ; p < /= 0.001 ) . A significantly greater proportion of patients achieved an LDL-C goal < 2.50 mmol/l with EZE/SIMVA than ATV ( 77.9 vs. 51.9 % ; p < or= 0.001 ) . Significant improvements in total cholesterol ( -20.3 vs. -13.0 % ) , non-high-density lipoprotein cholesterol ( non-HDL-C ) ( -27.9 vs. -17.0 % ) , apolipoprotein B ( -23.4 vs. -14.7 % ) and HDL-C ( 1.8 vs. -0.4 % ) were observed after switching to EZE/SIMVA 10/20 mg for 6 weeks ( p < 0.05 for all parameters ) . EZE/SIMVA 10/20 mg was generally well tolerated , with an overall safety profile similar to that of ATV 20 mg . EZE/SIMVA 10/20 mg produced superior lipid-altering efficacy by dual inhibition of cholesterol synthesis and intestinal absorption compared with doubling the dose of ATV from 10 to 20 mg
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 .