Half-dose ezetimibe add-on to statin therapy is effective in improving resistant hyperlipidaemia in Asian patients with ischaemic heart disease

Singapore Med J. 2011 Jun;52(6):400-4.

Abstract

Introduction: Ezetimibe at full dose (10-mg) is used for lipid lowering. We hypothesised that ezetimibe at half dose is effective in achieving percentage improvement in lipid profile among Asian patients with severe hyperlipidaemia.

Methods: This was a prospective cohort study conducted between 2006 and 2008. 105 patients with hyperlipidaemia not reaching target level with statin treatment alone were given add-on ezetimibe 5-mg daily treatment. Lipid profiles were compared at pre- and post-ezetimibe therapy.

Results: The mean age of the patients was 56.0 +/- 10.3 years. 79.0 percent were male and 62.9 percent had hypertension, 39 percent had diabetes mellitus with a mean HBA1c of 7.7 percent. 58.1 percent had a history of myocardial infarction. The median simvastatin equivalent dose was 40 (range 5-80) mg. Duration of ezetimibe treatment was 102 +/- 60 days. We observed improvements in total cholesterol (TC) (from 5.31 +/- 1.02 to 4.33 +/- 1.11 mmol/l, 16.4 percent reduction, p-value less than 0.0005), low density lipoprotein (LDL) (from 3.43 +/- 0.87 to 2.52 +/- 0.95 mmol/l, 24.0 percent reduction, p-value less than 0.0005) and TC to LDL ratio (from 4.92 +/-1.42 to 4.03 +/-1.16, 16.2 percent reduction, p-value less than 0.0005). The percentage improvement of lipid profile was comparable to that of the published data based on 10-mg dosing.

Conclusion: A 5-mg dose of daily ezetimibe add-on treatment is effective in improving lipid profiles in Asian patients with severe hyperlipidaemia not reaching target with statin monotherapy.

MeSH terms

  • Aged
  • Asia
  • Azetidines / administration & dosage*
  • Cholesterol / metabolism
  • Cohort Studies
  • Ezetimibe
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Hyperlipidemias / drug therapy*
  • Lipoproteins, LDL / metabolism
  • Male
  • Middle Aged
  • Myocardial Infarction / complications
  • Prospective Studies
  • Simvastatin / therapeutic use
  • Treatment Outcome

Substances

  • Azetidines
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipoproteins, LDL
  • Cholesterol
  • Simvastatin
  • Ezetimibe