The efficacy of statin monotherapy uptitration versus switching to ezetimibe/simvastatin: results of the EASEGO study

被引:0
作者
van Lennep, Henk W. O. Roeters [2 ]
Liem, An Ho [2 ]
Dunselman, Peter H. J. M. [3 ,4 ]
Dallinga-Thie, Geesje M. [5 ]
Zwinderman, Aeilko H. [5 ]
Jukema, J. Wouter [1 ]
机构
[1] Leiden Univ, Med Ctr, Dept Cardiol, NL-2300 RC Leiden, Netherlands
[2] Oosterscheldeziekenhuizen, Goes, Netherlands
[3] Univ Groningen, Dept Pharmacol, NL-9700 AB Groningen, Netherlands
[4] Amphia Ziekenhuis, Breda, Netherlands
[5] Univ Amsterdam, Acad Med Ctr, NL-1105 AZ Amsterdam, Netherlands
关键词
atorvastatin; cardiovascular disease; Ezetimibe; LDL-C lowering; LDL-subfractions; simvastatin;
D O I
10.1185/03007990SX273273
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To assess the incremental low-density lipoprotein-cholesterol (LDL-C) lowering efficacy of doubling the statin dose or switching to the ezetimibe/simvastatin 10/20 mg combination tablet (EZE/SIMVA) in patients on simvastatin 20 mg or atorvastatin 10 mg not at LDL-C target < 2.5 mmol/L. Study design and methods: Patients with documented coronary heart disease (CHD) and/or type 2 diabetes (DM2) with LDL-C >= 2.5 and < 5.0 mmol/L despite treatment with atorvastatin 10 mg or simvastatin 20 mg were randomized to (1) double statin dose or (2) switch to ezetimibe/simvastatin 10/20, according to a PROBE study design. LDL-C, lipoprotein subfractions and safety data were assessed during the study. Results: 119 of 178 (67%) patients in the EZE/SIMVA group and 49 of 189 (26%) in the doubling statin group reached target LDL-C < 2.5 mmol/L. The odds ratio of success for EZE/SIMVA versus doubling statin treatment in reaching the LDL-C target of < 2.5 mmol/L was 5.7 (95% Cl: 3.7-9.0, p < 0.0001). A reduction in total cholesterol (TC), total/high density lipoprotein (HDL) cholesterol ratio and apolipoprotein B was observed in both groups, but this reduction was significantly more pronounced in the EZE/SIMVA group as compared with the doubling statin dose group. Treatment was well tolerated and no difference was observed between the two groups with regard to adverse effects. Conclusions: In CHD/DM2 patients treated with simvastatin or atorvastatin with LDL-C persistently >= 2.5 mmol/L, switching to the EZE/SIMVA was more effective in attaining the LDL-C target of < 2.5 mmol/L than doubling the statin dose.
引用
收藏
页码:685 / 694
页数:10
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