Statin and ezetimibe combination therapy in cardiovascular disease.
OBJECTIVE
To summarize the available data regarding the benefits of combination therapy with statins and ezetimibe in patients with cardiovascular disease.


RESULTS
Extensive evidence, mostly in statin outcome trials, has shown that the magnitude of cardiovascular benefit is directly proportional to the degree of LDL cholesterol (LDL-C) reduction. As such, aggressive target goals for LDL-C levels have been established by guideline committees. Although statins are considered first-line agents in lipid therapy, LDL-C targets are difficult to achieve with statin therapy alone. Ezetimibe, a cholesterol absorption inhibitor, has been shown to be well tolerated and effective in lowering LDL-C. Adding ezetimibe to ongoing statin therapy leads to a substantial additional reduction in LDL-C, facilitating the achievement of target goals.


CONCLUSIONS
The combination of ezetimibe, a cholesterol absorption inhibitor, and statins has been shown to be well tolerated and effective in lowering LDL-C and high-sensitivity C-reactive protein to target goals. Whether this greater LDL-C reduction translates into reduced cardiovascular events is the subject of ongoing clinical trials. Until such data is available, ezetimibe seems to be a reasonable choice for a second-line, lipid-lowering agent in patients on a potent statin who are not at their LDL-C goal.
Dembowski
Ewa
E
Section of Cardiology, The University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Davidson
Michael H
MH
D000818:Animals; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D004359:Drug Therapy, Combination; D000069438:Ezetimibe; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D001384:Azetidines; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069438:Ezetimibe