title: Retrospective study on antihyperlipidemic efficacy and safety of simvastatin, ezetimibe and their combination in Korean adults.
abstract: Antihyperlipidemic agents such as 3-hydroxymethyglutaryl-coenzyme A reductase inhibitors and cholesterol transporter inhibitors are used in coronary heart disease. However, controversy remains over the pharmacologic effects and safety of these drugs, especially when used in combination therapies. This retrospective study evaluated the therapeutic effect and safety of simvastatin 20 mg and ezetimibe 10 mg combination therapy compared to simvastatin 20 mg or ezetimibe 10 mg monotherapy in Korean patients according to gender, age, baseline low-density lipoprotein cholesterol, and cardiovascular risk factors. We observed significant differences among patient subgroups. Simvastatin and ezetimibe monotherapies and combination therapy reduced low-density lipoprotein cholesterol levels by 27.6%, 10.1%, and 36.8% (p < 0.001) and total cholesterol levels by 17.5%, 9.2%, and 25.3% (p < 0.001), respectively. Both monotherapy and combination therapy groups had similar incidences of all types of adverse events. However, one case of rhabdomyolysis was observed in the combination therapy group. These results suggest that, compared to monotherapy, combination therapy has an additive effect that is not influenced by risk factors. Despite the low incidence of adverse events, caution is required when using these drugs, especially in the context of musculoskeletal side effects.
authors: Department of Pharmacy, Ajou University Hospital, Suwon 443-721, Korea.
authors: Young-Hee
authors: YH
authors: Lee
authors: Mi-Jeong
authors: MJ
authors: Kim
authors: Chang-Ik
authors: CI
authors: Choi
authors: Jung-Woo
authors: JW
authors: Bae
authors: Choon-Gon
authors: CG
authors: Jang
authors: Seok-Yong
authors: SY
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001384:Azetidines / Q000009:adverse effects / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood / Q000378:metabolism; D003327:Coronary Disease / Q000188:drug therapy / Q000378:metabolism*; D004338:Drug Combinations; D004357:Drug Synergism; D000069438:Ezetimibe; D000069499:Ezetimibe, Simvastatin Drug Combination; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007723:Korea; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D019821:Simvastatin / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood / Q000378:metabolism
chemical_list: D001384:Azetidines; D008078:Cholesterol, LDL; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol; D019821:Simvastatin; D000069438:Ezetimibe