LDL-C goal attainment with ezetimibe plus simvastatin coadministration vs atorvastatin or simvastatin monotherapy in patients at high risk of CHD.

Abstract

AIMS:

To compare the proportion of patients at high risk for coronary heart disease (CHD) achieving the recommended low-density lipoprotein cholesterol (LDL-C) treatment goal of < 100 mg/dL and the optional LDL-C target of < 70 mg/dL with coadministration of ezetimibe and simvastatin (EZE/SIMVA) vs either atorvastatin or simvastatin monotherapy.

PATIENTS:

Patients with established CHD or CHD risk equivalent according to National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria with baseline LDL-C = 130 mg/dL and triglycerides (TG) < or = 350 mg/dL.

METHODS:

A post hoc analysis from 2 separate studies assessed the percentage of high-risk patients achieving the LDL-C targets (< 100 and < 70 mg/dL) after 6 weeks on the usual recommended starting doses of the following treatments: EZE/SIMVA (10/20 mg) vs atorvastatin (10 mg) or simvastatin (20 mg). Depending on the study, EZE/SIMVA 10/10 or 10/40 mg was also compared with either atorvastatin 10 mg or simvastatin 20 mg. Percent change in other lipid parameters from baseline to study endpoint was also examined.

RESULTS:

In both studies, the proportions of patients achieving an LDL-C of < 100 mg/dL were significantly (P < .001) greater for EZE/SIMVA 10/10, 10/20, or 10/40 mg vs either atorvastatin 10 mg or simvastatin 20 mg after 6 weeks. The percentage reaching the optional LDL-C treatment target of < 70 mg/dL was also significantly higher with EZE/SIMVA compared with either atorvastatin or simvastatin. Percent reduction in LDL-C was significantly (P < .001) larger with all doses of EZE/SIMVA (46% to 59%) compared with either atorvastatin 10 mg (37%) or simvastatin 20 mg (38%) monotherapy after 6 weeks. Changes in other lipid parameters consistently favored EZE/SIMVA vs statin monotherapy. All treatments were well tolerated in both studies.

CONCLUSION:

Patients at high risk for CHD are more likely to attain LDL-C treatment targets with the usual recommended starting dose of EZE/SIMVA (10 or 20 mg) therapy than with that of atorvastatin (10 mg) or simvastatin (20 mg) monotherapy.

• Authors: James McKenney, Christie M Ballantyne, Theodore A Feldman, William E Brady, Arvind Shah, Michael J Davies, Joanne Palmisano, Yale B Mitchel
• Journal: MedGenMed : Medscape general medicine (MedGenMed) Vol. 7 Issue 3 Pg. 3 (Jul 14 2005) ISSN: 1531-0132 [Electronic] United States
• PMID: 16369229 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anticholesteremic Agents
• Azetidines
• Cholesterol, LDL
• Heptanoic Acids
• Pyrroles
• Atorvastatin
• Simvastatin
• Ezetimibe

Topics

• Aged
• Anticholesteremic Agents (administration & dosage)
• Atorvastatin
• Azetidines (administration & dosage)
• Cholesterol, LDL (blood)
• Coronary Disease (blood)
• Drug Therapy, Combination
• Ezetimibe
• Female
• Heptanoic Acids (administration & dosage)
• Humans
• Male
• Middle Aged
• Pyrroles (administration & dosage)
• Risk Factors
• Simvastatin (administration & dosage)