title: Observational study of ezetimibe discontinuation in primary care practices in the UK.
abstract: OBJECTIVE
  We investigated the circumstances of ezetimibe discontinuation as its prescribing had been discouraged in some publications.
  
  
  METHODS
  Adults on stable lipid-modifying therapy (LMT) including ezetimibe, who then had >8 weeks cessation in their prescribed ezetimibe regimen (2010-2011) were identified from THIN UK primary care database. Lipid values and parallel changes to other LMT were described overall and in a sub-group with a history of diabetes, cardiovascular disease or familial hypercholesterolaemia (high-risk group).
  
  
  RESULTS
  Ezetimibe therapy stopped in 7087 patients after a mean of 38 months; 67.0% were in the high-risk group. No lipid readings were recorded for 16.1% of patients in the year before and 26.2% in the year after ezetimibe stopped; 11.0% and 12.4% in the high-risk group respectively. In the prior year, 60.2% patients with any lipid reading had a total cholesterol (T-cholesterol) <5 mmol/l and 59.2% had a T-cholesterol <5 mmol/l and LDL-cholesterol <3 mmol/l. In the high-risk group, 66.8% had a T-cholesterol <5 mmol/l, 38.9% had either a T-cholesterol <4 or a LDL-cholesterol <2 mmol/l and 29.4% had reached both targets. In both populations, 42% patients had 6 months' follow-up after ezetimibe stopped with no change to other LMT. An LMT change within 8 weeks (19%) was usually a new statin while 27% overall had a further ezetimibe prescription after 8-26 weeks.
  
  
  CONCLUSIONS
  Only absolute lipid values were included, as percentage change from baseline level may not be reliable. The study included a larger proportion of patients in Scotland relative to the UK population.
  
  
  CONCLUSIONS
  Prescribed ezetimibe often stopped without either a recent lipid value or attainment of optimal, or sometimes minimum, lipid targets. Patients did not always receive parallel intensification of other LMT or a further ezetimibe prescription within 6 months.
authors.affiliation: Grimsdyke House , Ravenscroft Park, London , UK.
authors.forename: Gillian C
authors.initials: GC
authors.lastname: Hall
authors.forename: Vian
authors.initials: V
authors.lastname: Amber
authors.forename: Chris
authors.initials: C
authors.lastname: O'Regan
authors.forename: Kevin
authors.initials: K
authors.lastname: Jameson
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D000924:Anticholesteremic Agents; D001384:Azetidines; D002784:Cholesterol / Q000097:blood; D016208:Databases, Factual; D057915:Drug Substitution; D000069438:Ezetimibe; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy; D011320:Primary Health Care; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D002784:Cholesterol; D000069438:Ezetimibe