Table 16

Quantitative syntheses of short-term harms and adherence to treatment, for ezetimibe plus statin combination therapy compared with statin monotherapy

Ezetimibe short-term harms and adherenceNumber of trials reporting outcomeNumber of participants in relevant treatment groupsNumber of participants with eventsOdds ratioLower CIUpper CI
Adherence to treatment
All trials42,46,48,115,127,130,139,142,143,149,156,16612562550200.970.741.27
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy13012682420.530.211.30
Participants experiencing at least one adverse event
All trials46–48,111,112,119,124,126,127,129,130,142,144,149,151,154,156,159,167,168,187211002349120.990.901.08
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy
Conditionally titrated dose (Fixed or conditional titration)47
13622421.070.661.73
Withdrawal due to an adverse event
All trials42,46–48,106,111,112,115,116,118,121,126,127,129,130,132,140,142–144,148,151,154,156,158,159,167–169,187,193,19432136674901.200.981.46
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy Fixed dose121,130,1693582271.430.494.23
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy
Fixed dose or conditionally titrated47,121,130,169
41195591.130.572.25
Atorvastatin
Lower dose statin in combination therapy versus higher dose monotherapy
Fixed dose121,130,169
119420.200.014.22
AST and/or ALT ≥ 3 times the upper limit of normal, and/or hepatitis
All trials46–48,106,111,115,116,118,119,121,126,127,129,130,132,140,142,144,148,149,154,156,159,167,169,193,19427157301251.350.941.94
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy – fixed dose or fixed titration48,121,130,169497181.280.315.30
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy – conditional or fixed titrations or fixed dose47,48,121,130,1695157391.510.405.75
Myalgia
All trials48,106,109,112,114,124,126,130,140,142,146,154,156,167,1811550501250.920.641.33
CPK ≥ 10 times the ULN
All trials42,46–48,106,111,112,114–119,121,126,127,129,130,139,140,142,144,148,149,154,156,159,166–169,1933220220390.780.411.47
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy fixed dose or fixed titration 47,169231317.910.16399.42
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy47,121,16939153---
Rhabdomyolysis (investigator defined)
All trials46–48,111,112,114–116,129,132,142,146,148,154,156,159,167–1691981250---
Atorvastatin
Lower dose statin in combination therapy versus higher dose monotherapy 15915640---
Simvastatin
Lower dose statin in combination therapy versus higher dose monotherapy 47,16927130---

Abbreviations: ALT = alanine transaminase, AST = aspartate transaminase, CI = 95% confidence interval, CPK = creatinine phosphokinase, HDL-c = high density lipoprotein cholesterol, LDL-c = low density lipoprotein cholesterol, TC = total cholesterol, ULN = upper limit of normal

From: 3, Results

Cover of Comparative Effectiveness of Lipid-Modifying Agents
Comparative Effectiveness of Lipid-Modifying Agents [Internet].
Comparative Effectiveness Reviews, No. 16.
Sharma M, Ansari MT, Soares-Weiser K, et al.

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